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 $309.03 Median $436.52 Typical High $457.09 | Professional | None | $309.03 | $436.52 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,202.26 | Professional | None | $676.08 | $912.01 | $1,202.26 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $1,000.00 | Professional | None | $371.54 | $436.52 | $1,000.00 |
Pacific Source Setting Facility Modifier None Typical Low $457.09 Median $758.58 Typical High $912.01 | Facility | None | $457.09 | $758.58 | $912.01 |
Providence Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,659,586.91 | Facility | None | $977.24 | $977.24 | $1,659,586.91 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $1,148.15 | Professional | None | $416.87 | $549.54 | $1,148.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $389.05 Median $562.34 Typical High $630.96 | Facility | None | $389.05 | $562.34 | $630.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $794.33 | Professional | None | $645.65 | $724.44 | $794.33 |
United Setting Facility Modifier None Typical Low $562.34 Median $707.95 Typical High $870.96 | Facility | None | $562.34 | $707.95 | $870.96 |
United Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $1,258.93 | Professional | None | $446.68 | $660.69 | $1,258.93 |
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 $204.17 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $204.17 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $208.93 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $85.11 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $42.66 | $43.65 | $43.65 |
Where Oregon sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 3rd of 51
$631
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.