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 $33.88 Median $67.61 Typical High $114.82 | Professional | None | $33.88 | $67.61 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $95.50 Typical High $208.93 | Professional | None | $41.69 | $95.50 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $83.18 Typical High $213.80 | Professional | None | $45.71 | $83.18 | $213.80 |
Moda Health Setting Facility Modifier None Typical Low $52.48 Median $114.82 Typical High $218.78 | Facility | None | $52.48 | $114.82 | $218.78 |
Moda Health Setting Professional Modifier None Typical Low $37.15 Median $91.20 Typical High $162.18 | Professional | None | $37.15 | $91.20 | $162.18 |
Pacific Source Setting Facility Modifier None Typical Low $89.13 Median $154.88 Typical High $165.96 | Facility | None | $89.13 | $154.88 | $165.96 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $120.23 Typical High $218.78 | Facility | None | $45.71 | $120.23 | $218.78 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $83.18 Typical High $204.17 | Professional | None | $46.77 | $83.18 | $204.17 |
Regence BlueShield Setting Facility Modifier None Typical Low $181.97 Median $245.47 Typical High $288.40 | Facility | None | $181.97 | $245.47 | $288.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $53.70 Median $93.33 Typical High $165.96 | Professional | None | $53.70 | $93.33 | $165.96 |
United Setting Facility Modifier None Typical Low $229.09 Median $288.40 Typical High $354.81 | Facility | None | $229.09 | $288.40 | $354.81 |
United Setting Professional Modifier None Typical Low $47.86 Median $100.00 Typical High $218.78 | Professional | None | $47.86 | $100.00 | $218.78 |
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 $18.20 Median $34.67 Typical High $56.23 | Professional | 52 · Reduced service | $18.20 | $34.67 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $13.80 Typical High $22.91 | Professional | 53 · Discontinued | $7.41 | $13.80 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $10.47 Typical High $16.98 | Professional | 55 · Aftercare only | $5.50 | $10.47 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.92 Typical High $11.48 | Professional | 56 · Pre-op care only | $3.72 | $6.92 | $11.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $28.18 Typical High $56.23 | Professional | 52 · Reduced service | $18.20 | $28.18 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $11.22 Typical High $22.91 | Professional | 53 · Discontinued | $7.41 | $11.22 | $22.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $8.51 Typical High $16.98 | Professional | 55 · Aftercare only | $5.50 | $8.51 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.62 Typical High $11.48 | Professional | 56 · Pre-op care only | $3.72 | $5.62 | $11.48 |
Where Oregon sits
The same service costs 3.6 times more in North Carolina than in Washington, DC. 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· 11th of 51
$91.20
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.