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 $100.00 Median $134.90 Typical High $186.21 | Professional | None | $100.00 | $134.90 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $295.12 | Professional | None | $109.65 | $181.97 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $331.13 | Professional | None | $154.88 | $229.09 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $190.55 Typical High $309.03 | Facility | None | $134.90 | $190.55 | $309.03 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $354.81 | Professional | None | $123.03 | $186.21 | $354.81 |
Pacific Source Setting Facility Modifier None Typical Low $125.89 Median $245.47 Typical High $257.04 | Facility | None | $125.89 | $245.47 | $257.04 |
Providence Setting Facility Modifier None Typical Low $109.65 Median $234.42 Typical High $309.03 | Facility | None | $109.65 | $234.42 | $309.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $186.21 Typical High $295.12 | Professional | None | $79.43 | $186.21 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $229.09 Median $338.84 Typical High $524.81 | Facility | None | $229.09 | $338.84 | $524.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $223.87 | Professional | None | $154.88 | $208.93 | $223.87 |
United Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $309.03 | Professional | None | $141.25 | $208.93 | $309.03 |
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 $56.23 Median $67.61 Typical High $93.33 | Professional | 52 · Reduced service | $56.23 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.95 Typical High $27.54 | Professional | 55 · Aftercare only | $16.98 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.48 | $13.49 | $18.62 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $173.78 Median $331.13 Typical High $457.09 | Professional | 25 · Same-day visit | $173.78 | $331.13 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $67.61 Typical High $93.33 | Professional | 52 · Reduced service | $63.10 | $67.61 | $93.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $27.54 | Professional | 55 · Aftercare only | $19.05 | $19.95 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.59 | $13.49 | $18.62 |
Where Oregon sits
The same service costs 2.7 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
$186
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.