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 $11.48 Median $11.48 Typical High $13.49 | Professional | None | $11.48 | $11.48 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $24.55 Typical High $28.84 | Facility | None | $13.80 | $24.55 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.80 | Professional | None | $11.48 | $11.48 | $13.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.95 Median $30.20 Typical High $36.31 | Professional | None | $19.95 | $30.20 | $36.31 |
Moda Health Setting Facility Modifier None Typical Low $11.48 Median $12.30 Typical High $28.84 | Facility | None | $11.48 | $12.30 | $28.84 |
Moda Health Setting Professional Modifier None Typical Low $11.48 Median $13.49 Typical High $14.45 | Professional | None | $11.48 | $13.49 | $14.45 |
Pacific Source Setting Facility Modifier None Typical Low $12.30 Median $15.49 Typical High $26.92 | Facility | None | $12.30 | $15.49 | $26.92 |
Providence Setting Facility Modifier None Typical Low $11.48 Median $24.55 Typical High $34.67 | Facility | None | $11.48 | $24.55 | $34.67 |
Providence Setting Professional Modifier None Typical Low $11.48 Median $14.79 Typical High $70.79 | Professional | None | $11.48 | $14.79 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $12.02 Median $28.18 Typical High $58.88 | Facility | None | $12.02 | $28.18 | $58.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $10.72 Median $11.48 Typical High $11.48 | Professional | None | $10.72 | $11.48 | $11.48 |
United Setting Facility Modifier None Typical Low $11.48 Median $23.99 Typical High $27.54 | Facility | None | $11.48 | $23.99 | $27.54 |
United Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $15.85 | Professional | None | $13.80 | $13.80 | $15.85 |
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 $5.75 Median $5.75 Typical High $5.89 | Professional | 52 · Reduced service | $5.75 | $5.75 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.34 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $1.78 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $1.17 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $1.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 52 · Reduced service | $6.92 | $6.92 | $6.92 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.82 | $2.82 | $2.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $2.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.38 | $1.38 | $1.38 |
Where Oregon sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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
$12.59
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.