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 $18.62 Median $39.81 Typical High $39.81 | Professional | None | $18.62 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $112.20 Typical High $138.04 | Professional | None | $43.65 | $112.20 | $138.04 |
Moda Health Setting Facility Modifier None Typical Low $39.81 Median $52.48 Typical High $56.23 | Facility | None | $39.81 | $52.48 | $56.23 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $56.23 | Professional | None | $39.81 | $52.48 | $56.23 |
Pacific Source Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $53.70 | Facility | None | $52.48 | $52.48 | $53.70 |
Providence Setting Facility Modifier None Typical Low $35.48 Median $46.77 Typical High $60.26 | Facility | None | $35.48 | $46.77 | $60.26 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $46.77 Typical High $79.43 | Professional | None | $25.70 | $46.77 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $44.67 Median $85.11 Typical High $208.93 | Facility | None | $44.67 | $85.11 | $208.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | None | $56.23 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $23.44 Median $24.55 Typical High $47.86 | Professional | None | $23.44 | $24.55 | $47.86 |
8 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 $19.05 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.05 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.59 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $5.75 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.80 | $3.98 | $3.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.05 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.59 | $7.94 | $7.94 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $5.75 | $5.89 | $5.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.80 | $3.98 | $3.98 |
Where Oregon sits
The same service costs 2.2 times more in Hawaii than in Utah. 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· 12th of 51
$47.86
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.