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 $40.74 Median $40.74 Typical High $41.69 | Professional | None | $40.74 | $40.74 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $28.84 | Professional | None | $25.70 | $25.70 | $28.84 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $58.88 Typical High $66.07 | Facility | None | $28.18 | $58.88 | $66.07 |
Moda Health Setting Professional Modifier None Typical Low $29.51 Median $40.74 Typical High $41.69 | Professional | None | $29.51 | $40.74 | $41.69 |
Pacific Source Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Providence Setting Facility Modifier None Typical Low $40.74 Median $56.23 Typical High $66.07 | Facility | None | $40.74 | $56.23 | $66.07 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $79.43 | Professional | None | $25.70 | $25.70 | $79.43 |
United Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $81.28 | Professional | None | $60.26 | $70.79 | $81.28 |
4 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 $20.42 Median $20.42 Typical High $20.89 | Professional | 52 · Reduced service | $20.42 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.32 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $6.31 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.17 |
Where Oregon sits
The same service costs 3.1 times more in Wisconsin than in New York. 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· 35th of 51
$40.74
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.