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 $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Cigna Setting Facility Modifier None Typical Low $2.75 Median $3.02 Typical High $4.27 | Facility | None | $2.75 | $3.02 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.14 | Professional | None | $2.00 | $2.00 | $2.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.40 Median $3.72 Typical High $4.47 | Professional | None | $2.40 | $3.72 | $4.47 |
Moda Health Setting Facility Modifier None Typical Low $2.00 Median $2.09 Typical High $2.63 | Facility | None | $2.00 | $2.09 | $2.63 |
Moda Health Setting Professional Modifier None Typical Low $1.78 Median $2.00 Typical High $2.40 | Professional | None | $1.78 | $2.00 | $2.40 |
Pacific Source Setting Facility Modifier None Typical Low $1.20 Median $2.29 Typical High $4.37 | Facility | None | $1.20 | $2.29 | $4.37 |
Providence Setting Facility Modifier None Typical Low $2.00 Median $2.82 Typical High $4.27 | Facility | None | $2.00 | $2.82 | $4.27 |
Providence Setting Professional Modifier None Typical Low $1.95 Median $2.04 Typical High $2.51 | Professional | None | $1.95 | $2.04 | $2.51 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.91 Median $2.00 Typical High $2.00 | Professional | None | $1.91 | $2.00 | $2.00 |
United Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $2.04 | Professional | None | $1.78 | $1.78 | $2.04 |
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 $1.00 Median $1.00 Typical High $1.00 | Professional | 52 · Reduced service | $1.00 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 53 · Discontinued | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | 52 · Reduced service | $0.89 | $0.89 | $0.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 53 · Discontinued | $0.35 | $0.35 | $0.35 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 55 · Aftercare only | $0.27 | $0.27 | $0.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.18 |
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· 20th of 51
$2.00
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.