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 $120.23 Median $162.18 Typical High $263.03 | Facility | None | $120.23 | $162.18 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $162.18 | Professional | None | $87.10 | $120.23 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $263.03 | Professional | None | $95.50 | $162.18 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $288.40 | Professional | None | $138.04 | $199.53 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $186.21 Typical High $281.84 | Facility | None | $120.23 | $186.21 | $281.84 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $269.15 | Professional | None | $102.33 | $162.18 | $269.15 |
Pacific Source Setting Facility Modifier None Typical Low $131.83 Median $218.78 Typical High $229.09 | Facility | None | $131.83 | $218.78 | $229.09 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $204.17 Typical High $275.42 | Facility | None | $97.72 | $204.17 | $275.42 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $257.04 | Professional | None | $79.43 | $162.18 | $257.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $204.17 Median $302.00 Typical High $457.09 | Facility | None | $204.17 | $302.00 | $457.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $199.53 | Professional | None | $138.04 | $181.97 | $199.53 |
United Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $281.84 | Professional | None | $125.89 | $186.21 | $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 $50.12 Median $60.26 Typical High $81.28 | Professional | 52 · Reduced service | $50.12 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.78 Typical High $24.55 | Professional | 55 · Aftercare only | $15.14 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.02 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.00 | $12.02 | $16.22 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $141.25 Median $295.12 Typical High $389.05 | Professional | 25 · Same-day visit | $141.25 | $295.12 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $60.26 Typical High $81.28 | Professional | 52 · Reduced service | $50.12 | $60.26 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.78 Typical High $24.55 | Professional | 55 · Aftercare only | $16.60 | $17.78 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.02 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.96 | $12.02 | $16.22 |
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
$162
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.