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 $85.11 Median $85.11 Typical High $112.20 | Facility | None | $85.11 | $85.11 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $91.20 | Professional | None | $51.29 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $34.67 Typical High $45.71 | Professional | 52 · Reduced service | $29.51 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.23 Typical High $13.49 | Professional | 55 · Aftercare only | $8.71 | $10.23 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.92 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.89 | $6.92 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $89.13 Typical High $147.91 | Professional | None | $56.23 | $89.13 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $162.18 | Professional | None | $79.43 | $112.20 | $162.18 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $109.65 Typical High $147.91 | Facility | None | $69.18 | $109.65 | $147.91 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $138.04 | Professional | None | $60.26 | $91.20 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $34.67 Typical High $45.71 | Professional | 52 · Reduced service | $31.62 | $34.67 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.23 Typical High $13.49 | Professional | 55 · Aftercare only | $9.55 | $10.23 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.92 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.31 | $6.92 | $9.12 |
Pacific Source Setting Facility Modifier None Typical Low $72.44 Median $117.49 Typical High $125.89 | Facility | None | $72.44 | $117.49 | $125.89 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $117.49 Typical High $147.91 | Facility | None | $56.23 | $117.49 | $147.91 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $147.91 | Professional | None | $67.61 | $91.20 | $147.91 |
Regence BlueShield Setting Facility Modifier None Typical Low $114.82 Median $162.18 Typical High $257.04 | Facility | None | $114.82 | $162.18 | $257.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $109.65 | Professional | None | $79.43 | $100.00 | $109.65 |
United Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $154.88 | Professional | None | $74.13 | $104.71 | $154.88 |
1 more rate 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 |
|---|---|---|---|---|---|
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $89.13 Median $251.19 Typical High $323.59 | Professional | 25 · Same-day visit | $89.13 | $251.19 | $323.59 |
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
$91.20
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.