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 $123.03 Median $165.96 Typical High $263.03 | Facility | None | $123.03 | $165.96 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $165.96 | Professional | None | $91.20 | $123.03 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $269.15 | Professional | None | $97.72 | $165.96 | $269.15 |
HealthNet Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $323.59 | Professional | None | $295.12 | $295.12 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $302.00 | Professional | None | $141.25 | $204.17 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $281.84 | Facility | None | $123.03 | $173.78 | $281.84 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $346.74 | Professional | None | $109.65 | $165.96 | $346.74 |
Pacific Source Setting Facility Modifier None Typical Low $131.83 Median $223.87 Typical High $229.09 | Facility | None | $131.83 | $223.87 | $229.09 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $208.93 Typical High $281.84 | Facility | None | $100.00 | $208.93 | $281.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $263.03 | Professional | None | $79.43 | $165.96 | $263.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $208.93 Median $309.03 Typical High $467.74 | Facility | None | $208.93 | $309.03 | $467.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $204.17 | Professional | None | $141.25 | $186.21 | $204.17 |
United Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $288.40 | Professional | None | $128.82 | $190.55 | $288.40 |
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 $61.66 Typical High $83.18 | Professional | 52 · Reduced service | $50.12 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $18.62 Typical High $25.12 | Professional | 55 · Aftercare only | $15.49 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.30 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.23 | $12.30 | $16.60 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $141.25 Median $302.00 Typical High $380.19 | Professional | 25 · Same-day visit | $141.25 | $302.00 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $61.66 Typical High $83.18 | Professional | 52 · Reduced service | $56.23 | $61.66 | $83.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.62 Typical High $25.12 | Professional | 55 · Aftercare only | $16.98 | $18.62 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.48 | $12.30 | $16.60 |
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
$166
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.