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 $25.12 Median $36.31 Typical High $36.31 | Facility | None | $25.12 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $20.42 Typical High $20.42 | Professional | None | $14.79 | $20.42 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $27.54 Median $34.67 Typical High $44.67 | Professional | None | $27.54 | $34.67 | $44.67 |
Moda Health Setting Facility Modifier None Typical Low $16.22 Median $38.02 Typical High $58.88 | Facility | None | $16.22 | $38.02 | $58.88 |
Moda Health Setting Professional Modifier None Typical Low $17.78 Median $20.42 Typical High $36.31 | Professional | None | $17.78 | $20.42 | $36.31 |
Pacific Source Setting Facility Modifier None Typical Low $17.78 Median $29.51 Typical High $31.62 | Facility | None | $17.78 | $29.51 | $31.62 |
Providence Setting Facility Modifier None Typical Low $15.85 Median $34.67 Typical High $75.86 | Facility | None | $15.85 | $34.67 | $75.86 |
Providence Setting Professional Modifier None Typical Low $14.79 Median $28.18 Typical High $70.79 | Professional | None | $14.79 | $28.18 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $26.92 Median $37.15 Typical High $63.10 | Facility | None | $26.92 | $37.15 | $63.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $24.55 Median $26.92 Typical High $28.84 | Professional | None | $24.55 | $26.92 | $28.84 |
United Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $25.70 | Facility | None | $17.78 | $17.78 | $25.70 |
United Setting Professional Modifier None Typical Low $21.38 Median $27.54 Typical High $44.67 | Professional | None | $21.38 | $27.54 | $44.67 |
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 $7.41 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $7.41 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $2.95 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $2.24 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.48 | $2.04 | $2.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $7.76 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $3.09 | $4.07 | $4.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $2.29 | $3.09 | $3.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.55 | $2.04 | $2.04 |
Where Oregon sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 4th of 51
$25.12
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.