How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $138.04 | Professional | None | $112.20 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $323.59 | Professional | None | $134.90 | $190.55 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $288.40 | Professional | None | $204.17 | $251.19 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $138.04 Median $234.42 Typical High $295.12 | Facility | None | $138.04 | $234.42 | $295.12 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $229.09 | Professional | None | $138.04 | $138.04 | $229.09 |
Pacific Source Setting Facility Modifier None Typical Low $125.89 Median $208.93 Typical High $223.87 | Facility | None | $125.89 | $208.93 | $223.87 |
Providence Setting Facility Modifier None Typical Low $123.03 Median $234.42 Typical High $295.12 | Facility | None | $123.03 | $234.42 | $295.12 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $309.03 | Professional | None | $79.43 | $190.55 | $309.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $218.78 | Professional | None | $194.98 | $204.17 | $218.78 |
United Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $346.74 | Professional | None | $147.91 | $229.09 | $346.74 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $61.66 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $24.55 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $18.20 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.30 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $66.07 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $26.30 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $19.50 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.18 | $13.80 | $13.80 |
Where Oregon sits
The same service costs 2.8 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oregon· 7th of 51
$204
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.