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 $41.69 Median $41.69 Typical High $67.61 | Facility | None | $41.69 | $41.69 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $33.88 Typical High $54.95 | Professional | None | $28.18 | $33.88 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $47.86 Typical High $83.18 | Professional | None | $28.84 | $47.86 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $60.26 Typical High $100.00 | Professional | None | $38.90 | $60.26 | $100.00 |
Moda Health Setting Facility Modifier None Typical Low $33.88 Median $57.54 Typical High $87.10 | Facility | None | $33.88 | $57.54 | $87.10 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $79.43 | Professional | None | $32.36 | $48.98 | $79.43 |
Pacific Source Setting Facility Modifier None Typical Low $42.66 Median $67.61 Typical High $77.62 | Facility | None | $42.66 | $67.61 | $77.62 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $57.54 Typical High $87.10 | Facility | None | $28.18 | $57.54 | $87.10 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $60.26 Typical High $81.28 | Professional | None | $33.88 | $60.26 | $81.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $69.18 Median $97.72 Typical High $158.49 | Facility | None | $69.18 | $97.72 | $158.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $67.61 | Professional | None | $38.90 | $61.66 | $67.61 |
United Setting Professional Modifier None Typical Low $37.15 Median $58.88 Typical High $89.13 | Professional | None | $37.15 | $58.88 | $89.13 |
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 $15.85 Median $16.98 Typical High $27.54 | Professional | 52 · Reduced service | $15.85 | $16.98 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.13 Typical High $8.32 | Professional | 55 · Aftercare only | $4.79 | $5.13 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.39 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.24 | $3.39 | $5.62 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $46.77 Median $107.15 Typical High $158.49 | Professional | 25 · Same-day visit | $46.77 | $107.15 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $16.98 Typical High $27.54 | Professional | 52 · Reduced service | $16.98 | $16.98 | $27.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $8.32 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $8.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $5.62 |
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· 3rd of 51
$54.95
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.