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 $56.23 Median $56.23 Typical High $63.10 | Professional | None | $56.23 | $56.23 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $120.23 | Facility | None | $75.86 | $75.86 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | None | $56.23 | $56.23 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $120.23 Typical High $144.54 | Professional | None | $42.66 | $120.23 | $144.54 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $56.23 Typical High $72.44 | Facility | None | $54.95 | $56.23 | $72.44 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $70.79 | Professional | None | $54.95 | $56.23 | $70.79 |
Pacific Source Setting Facility Modifier None Typical Low $54.95 Median $69.18 Typical High $114.82 | Facility | None | $54.95 | $69.18 | $114.82 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $75.86 Typical High $120.23 | Facility | None | $56.23 | $75.86 | $120.23 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $79.43 | Professional | None | $53.70 | $61.66 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | None | $56.23 | $56.23 | $64.57 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $63.10 | Professional | None | $54.95 | $54.95 | $63.10 |
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 $28.18 Median $28.18 Typical High $30.90 | Professional | 52 · Reduced service | $28.18 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | 53 · Discontinued | $11.48 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $9.33 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $27.54 Typical High $28.84 | Professional | 52 · Reduced service | $27.54 | $27.54 | $28.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 53 · Discontinued | $10.96 | $10.96 | $11.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.71 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.75 |
Where Oregon sits
The same service costs 1.6 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· 11th of 51
$56.23
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.