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 $147.91 Median $181.97 Typical High $234.42 | Facility | None | $147.91 | $181.97 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $154.88 | Professional | None | $100.00 | $131.83 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $302.00 | Professional | None | $134.90 | $173.78 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $323.59 | Professional | None | $186.21 | $251.19 | $323.59 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $223.87 Typical High $691.83 | Facility | None | $147.91 | $223.87 | $691.83 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $288.40 | Professional | None | $107.15 | $162.18 | $288.40 |
Pacific Source Setting Facility Modifier None Typical Low $138.04 Median $234.42 Typical High $239.88 | Facility | None | $138.04 | $234.42 | $239.88 |
Providence Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $302.00 | Facility | None | $154.88 | $251.19 | $302.00 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $204.17 Typical High $316.23 | Professional | None | $79.43 | $204.17 | $316.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $269.15 | Professional | None | $177.83 | $199.53 | $269.15 |
United Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $338.84 | Professional | None | $162.18 | $213.80 | $338.84 |
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 $53.70 Median $66.07 Typical High $74.13 | Professional | 52 · Reduced service | $53.70 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $21.88 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.18 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.72 | $13.18 | $14.79 |
Moda Health Setting Facility Modifier 25 · Same-day visit Typical Low $346.74 Median $501.19 Typical High $1,174.90 | Facility | 25 · Same-day visit | $346.74 | $501.19 | $1,174.90 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $102.33 Median $257.04 Typical High $630.96 | Professional | 25 · Same-day visit | $102.33 | $257.04 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $66.07 Typical High $74.13 | Professional | 52 · Reduced service | $60.26 | $66.07 | $74.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $21.88 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.18 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.02 | $13.18 | $14.79 |
Where Oregon sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 7th of 51
$195
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.