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 $75.86 Median $79.43 Typical High $79.43 | Professional | None | $75.86 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $213.80 Typical High $257.04 | Professional | None | $83.18 | $213.80 | $257.04 |
Moda Health Setting Facility Modifier None Typical Low $77.62 Median $95.50 Typical High $109.65 | Facility | None | $77.62 | $95.50 | $109.65 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $109.65 | Professional | None | $79.43 | $100.00 | $109.65 |
Pacific Source Setting Facility Modifier None Typical Low $85.11 Median $104.71 Typical High $107.15 | Facility | None | $85.11 | $104.71 | $107.15 |
Pacific Source Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | None | $97.72 | $97.72 | $107.15 |
Providence Setting Facility Modifier None Typical Low $64.57 Median $93.33 Typical High $131.83 | Facility | None | $64.57 | $93.33 | $131.83 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $104.71 | Professional | None | $44.67 | $79.43 | $104.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | None | $112.20 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $89.13 | Professional | None | $42.66 | $45.71 | $89.13 |
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 $38.02 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $38.02 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.14 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.59 | $7.94 | $7.94 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $38.02 | $39.81 | $39.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.14 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.59 | $7.94 | $7.94 |
Where Oregon sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 17th of 51
$85.11
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.