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 Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $162.18 | Professional | None | $83.18 | $112.20 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $257.04 | Professional | None | $93.33 | $154.88 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $288.40 | Professional | None | $128.82 | $199.53 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $177.83 Typical High $275.42 | Facility | None | $112.20 | $177.83 | $275.42 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $239.88 | Professional | None | $100.00 | $151.36 | $239.88 |
Pacific Source Setting Facility Modifier None Typical Low $128.82 Median $218.78 Typical High $229.09 | Facility | None | $128.82 | $218.78 | $229.09 |
Providence Setting Facility Modifier None Typical Low $91.20 Median $190.55 Typical High $275.42 | Facility | None | $91.20 | $190.55 | $275.42 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $257.04 | Professional | None | $79.43 | $154.88 | $257.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $199.53 Median $295.12 Typical High $457.09 | Facility | None | $199.53 | $295.12 | $457.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $199.53 | Professional | None | $128.82 | $181.97 | $199.53 |
United Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $269.15 | Professional | None | $120.23 | $181.97 | $269.15 |
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 $51.29 Median $56.23 Typical High $81.28 | Professional | 52 · Reduced service | $51.29 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.98 Typical High $24.55 | Professional | 55 · Aftercare only | $15.49 | $16.98 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.23 | $11.22 | $16.22 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $131.83 Median $316.23 Typical High $407.38 | Professional | 25 · Same-day visit | $131.83 | $316.23 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $56.23 Typical High $81.28 | Professional | 52 · Reduced service | $54.95 | $56.23 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.98 Typical High $24.55 | Professional | 55 · Aftercare only | $16.60 | $16.98 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.96 | $11.22 | $16.22 |
Where Oregon sits
The same service costs 2.8 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· 5th of 51
$158
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.