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 $72.44 Median $72.44 Typical High $79.43 | Professional | None | $72.44 | $72.44 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $112.20 Typical High $158.49 | Facility | None | $95.50 | $112.20 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | None | $72.44 | $72.44 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $158.49 Typical High $190.55 | Professional | None | $54.95 | $158.49 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $74.13 Typical High $117.49 | Facility | None | $72.44 | $74.13 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $91.20 | Professional | None | $72.44 | $74.13 | $91.20 |
Pacific Source Setting Facility Modifier None Typical Low $69.18 Median $87.10 Typical High $151.36 | Facility | None | $69.18 | $87.10 | $151.36 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $112.20 Typical High $158.49 | Facility | None | $72.44 | $112.20 | $158.49 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $100.00 | Professional | None | $72.44 | $79.43 | $100.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | None | $72.44 | $72.44 | $83.18 |
United Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | None | $74.13 | $74.13 | $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 $36.31 Median $36.31 Typical High $39.81 | Professional | 52 · Reduced service | $36.31 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $16.22 | Professional | 53 · Discontinued | $14.45 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $12.02 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.94 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $37.15 | $37.15 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $14.79 | $14.79 | $15.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.76 |
Where Oregon sits
The same service costs 1.6 times more in Hawaii than in Delaware. 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· 31st of 51
$74.13
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.