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 $8.13 Median $10.00 Typical High $12.02 | Facility | None | $8.13 | $10.00 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $17.38 Typical High $19.95 | Facility | None | $10.72 | $17.38 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.12 | Professional | None | $8.13 | $8.13 | $9.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.47 Median $16.22 Typical High $19.95 | Professional | None | $10.47 | $16.22 | $19.95 |
Moda Health Setting Facility Modifier None Typical Low $8.13 Median $15.14 Typical High $60.26 | Facility | None | $8.13 | $15.14 | $60.26 |
Moda Health Setting Professional Modifier None Typical Low $7.24 Median $8.13 Typical High $9.33 | Professional | None | $7.24 | $8.13 | $9.33 |
Pacific Source Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $15.85 | Facility | None | $7.59 | $7.59 | $15.85 |
Providence Setting Facility Modifier None Typical Low $8.13 Median $12.88 Typical High $19.95 | Facility | None | $8.13 | $12.88 | $19.95 |
Providence Setting Professional Modifier None Typical Low $8.13 Median $9.55 Typical High $79.43 | Professional | None | $8.13 | $9.55 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | None | $7.76 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $8.32 | Professional | None | $7.24 | $7.24 | $8.32 |
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 $4.07 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 52 · Reduced service | $3.63 | $3.63 | $3.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $0.72 |
Where Oregon sits
Rates are fairly even across states for this service. 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· 39th of 51
$8.13
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.