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 $19.50 Median $48.98 Typical High $48.98 | Professional | None | $19.50 | $48.98 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $51.29 Median $131.83 Typical High $158.49 | Professional | None | $51.29 | $131.83 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $47.86 Median $57.54 Typical High $67.61 | Facility | None | $47.86 | $57.54 | $67.61 |
Moda Health Setting Professional Modifier None Typical Low $48.98 Median $60.26 Typical High $67.61 | Professional | None | $48.98 | $60.26 | $67.61 |
Pacific Source Setting Facility Modifier None Typical Low $52.48 Median $64.57 Typical High $66.07 | Facility | None | $52.48 | $64.57 | $66.07 |
Pacific Source Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | None | $66.07 | $66.07 | $72.44 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $56.23 Typical High $81.28 | Facility | None | $39.81 | $56.23 | $81.28 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $57.54 Typical High $79.43 | Professional | None | $33.88 | $57.54 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $74.13 | Professional | None | $69.18 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $26.30 Median $28.18 Typical High $54.95 | Professional | None | $26.30 | $28.18 | $54.95 |
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 $23.44 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $23.44 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.33 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $7.08 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.68 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $23.44 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.33 | $9.77 | $9.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $7.08 | $7.24 | $7.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.68 | $4.90 | $4.90 |
Where Oregon sits
The same service costs 2.3 times more in Kansas than in Alabama. 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· 19th of 51
$53.70
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.