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 $162.18 Median $162.18 Typical High $190.55 | Facility | None | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $208.93 | Professional | None | $147.91 | $177.83 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $398.11 | Professional | None | $162.18 | $234.42 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $398.11 | Professional | None | $251.19 | $316.23 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $269.15 Typical High $436.52 | Facility | None | $147.91 | $269.15 | $436.52 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $309.03 | Professional | None | $147.91 | $199.53 | $309.03 |
Pacific Source Setting Facility Modifier None Typical Low $208.93 Median $316.23 Typical High $346.74 | Facility | None | $208.93 | $316.23 | $346.74 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $295.12 Typical High $436.52 | Facility | None | $141.25 | $295.12 | $436.52 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $263.03 Typical High $407.38 | Professional | None | $79.43 | $263.03 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $467.74 Typical High $660.69 | Facility | None | $323.59 | $467.74 | $660.69 |
United Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $436.52 | Professional | None | $213.80 | $295.12 | $436.52 |
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 $74.13 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $74.13 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $26.92 | Professional | 55 · Aftercare only | $22.39 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.79 | $16.22 | $17.78 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $524.81 Median $616.60 Typical High $707.95 | Professional | 25 · Same-day visit | $524.81 | $616.60 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $81.28 Typical High $89.13 | Professional | 52 · Reduced service | $74.13 | $81.28 | $89.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $26.92 | Professional | 55 · Aftercare only | $22.39 | $24.55 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.79 | $16.22 | $17.78 |
Where Oregon sits
The same service costs 2.3 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· 9th of 51
$209
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.