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 $100.00 Median $100.00 Typical High $128.82 | Facility | None | $100.00 | $100.00 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $208.93 | Professional | None | $93.33 | $141.25 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $269.15 | Professional | None | $102.33 | $162.18 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $269.15 | Professional | None | $128.82 | $194.98 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $93.33 Median $208.93 Typical High $295.12 | Facility | None | $93.33 | $208.93 | $295.12 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $208.93 | Professional | None | $93.33 | $151.36 | $208.93 |
Pacific Source Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $234.42 | Facility | None | $138.04 | $223.87 | $234.42 |
Providence Setting Facility Modifier None Typical Low $91.20 Median $204.17 Typical High $288.40 | Facility | None | $91.20 | $204.17 | $288.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $275.42 | Professional | None | $79.43 | $173.78 | $275.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $213.80 Median $316.23 Typical High $457.09 | Facility | None | $213.80 | $316.23 | $457.09 |
United Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $288.40 | Professional | None | $138.04 | $190.55 | $288.40 |
7 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 $45.71 Median $51.29 Typical High $58.88 | Professional | 52 · Reduced service | $45.71 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.23 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.33 | $10.23 | $12.02 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $338.84 Median $436.52 Typical High $467.74 | Professional | 25 · Same-day visit | $338.84 | $436.52 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $51.29 Typical High $58.88 | Professional | 52 · Reduced service | $45.71 | $51.29 | $58.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.23 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.33 | $10.23 | $12.02 |
Where Oregon sits
The same service costs 2.5 times more in Alaska than in Alabama. 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· 3rd of 51
$166
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.