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 $218.78 Median $223.87 Typical High $295.12 | Facility | None | $218.78 | $223.87 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $239.88 | Professional | None | $177.83 | $204.17 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $512.86 | Professional | None | $204.17 | $302.00 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $524.81 | Professional | None | $338.84 | $416.87 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $295.12 Typical High $575.44 | Facility | None | $199.53 | $295.12 | $575.44 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $398.11 | Professional | None | $177.83 | $229.09 | $398.11 |
Pacific Source Setting Facility Modifier None Typical Low $257.04 Median $407.38 Typical High $426.58 | Facility | None | $257.04 | $407.38 | $426.58 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $380.19 Typical High $524.81 | Facility | None | $186.21 | $380.19 | $524.81 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $346.74 Typical High $524.81 | Professional | None | $79.43 | $346.74 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $389.05 Median $575.44 Typical High $851.14 | Facility | None | $389.05 | $575.44 | $851.14 |
United Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $562.34 | Professional | None | $275.42 | $363.08 | $562.34 |
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 $91.20 Median $100.00 Typical High $107.15 | Professional | 52 · Reduced service | $91.20 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $32.36 | Professional | 55 · Aftercare only | $27.54 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $21.88 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $691.83 Median $776.25 Typical High $851.14 | Professional | 25 · Same-day visit | $691.83 | $776.25 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $100.00 Typical High $107.15 | Professional | 52 · Reduced service | $91.20 | $100.00 | $107.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $32.36 | Professional | 55 · Aftercare only | $27.54 | $30.20 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.42 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.20 | $20.42 | $21.88 |
Where Oregon sits
The same service costs 2.4 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· 8th of 51
$275
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.