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 Facility Modifier None Typical Low $169.82 Median $288.40 Typical High $389.05 | Facility | None | $169.82 | $288.40 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $190.55 | Professional | None | $104.71 | $144.54 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $323.59 | Professional | None | $138.04 | $190.55 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $234.42 | Professional | None | $151.36 | $199.53 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $281.84 Typical High $354.81 | Facility | None | $190.55 | $281.84 | $354.81 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $309.03 | Professional | None | $109.65 | $154.88 | $309.03 |
Pacific Source Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $257.04 | Facility | None | $151.36 | $190.55 | $257.04 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $275.42 Typical High $354.81 | Facility | None | $100.00 | $275.42 | $354.81 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $213.80 Typical High $295.12 | Professional | None | $79.43 | $213.80 | $295.12 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $288.40 | Professional | None | $162.18 | $169.82 | $288.40 |
United Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $331.13 | Professional | None | $158.49 | $239.88 | $331.13 |
6 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 $50.12 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $50.12 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $15.14 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.00 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $50.12 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $15.14 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.00 | $15.49 | $15.49 |
Where Oregon sits
The same service costs 2.0 times more in Alaska 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· 9th of 51
$170
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.