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 $89.13 Median $120.23 Typical High $169.82 | Professional | None | $89.13 | $120.23 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $269.15 | Professional | None | $97.72 | $162.18 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $302.00 | Professional | None | $138.04 | $204.17 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $177.83 Typical High $288.40 | Facility | None | $120.23 | $177.83 | $288.40 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $257.04 | Professional | None | $100.00 | $158.49 | $257.04 |
Pacific Source Setting Facility Modifier None Typical Low $128.82 Median $223.87 Typical High $239.88 | Facility | None | $128.82 | $223.87 | $239.88 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $204.17 Typical High $288.40 | Facility | None | $97.72 | $204.17 | $288.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $263.03 | Professional | None | $79.43 | $162.18 | $263.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $208.93 Median $309.03 Typical High $478.63 | Facility | None | $208.93 | $309.03 | $478.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $208.93 | Professional | None | $138.04 | $190.55 | $208.93 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $281.84 | Professional | None | $125.89 | $190.55 | $281.84 |
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 $52.48 Median $60.26 Typical High $85.11 | Professional | 52 · Reduced service | $52.48 | $60.26 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $17.78 Typical High $25.12 | Professional | 55 · Aftercare only | $15.85 | $17.78 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.02 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.47 | $12.02 | $16.98 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $131.83 Median $338.84 Typical High $416.87 | Professional | 25 · Same-day visit | $131.83 | $338.84 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $60.26 Typical High $85.11 | Professional | 52 · Reduced service | $57.54 | $60.26 | $85.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.78 Typical High $25.12 | Professional | 55 · Aftercare only | $17.38 | $17.78 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.02 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.48 | $12.02 | $16.98 |
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
$170
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.