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 $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $43.65 Typical High $61.66 | Facility | None | $26.30 | $43.65 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $30.90 | Professional | None | $28.84 | $28.84 | $30.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $63.10 | Professional | None | $35.48 | $53.70 | $63.10 |
Moda Health Setting Facility Modifier None Typical Low $24.55 Median $30.20 Typical High $36.31 | Facility | None | $24.55 | $30.20 | $36.31 |
Moda Health Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $34.67 | Professional | None | $24.55 | $28.84 | $34.67 |
Pacific Source Setting Facility Modifier None Typical Low $21.88 Median $32.36 Typical High $44.67 | Facility | None | $21.88 | $32.36 | $44.67 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $43.65 Typical High $87.10 | Facility | None | $28.84 | $43.65 | $87.10 |
Providence Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $79.43 | Professional | None | $28.84 | $29.51 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $38.90 Median $69.18 Typical High $104.71 | Facility | None | $38.90 | $69.18 | $104.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $27.54 Median $28.84 Typical High $28.84 | Professional | None | $27.54 | $28.84 | $28.84 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $28.18 | Professional | None | $24.55 | $24.55 | $28.18 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.90 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Where Oregon sits
The same service costs 2.8 times more in Wyoming than in Arizona. 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· 17th of 51
$28.84
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.