How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $51.29 Typical High $102.33 | Facility | None | $15.14 | $51.29 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.99 Median $169.82 Typical High $177.83 | Professional | None | $23.99 | $169.82 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $8.13 Median $66.07 Typical High $72.44 | Facility | None | $8.13 | $66.07 | $72.44 |
Moda Health Setting Professional Modifier None Typical Low $13.80 Median $50.12 Typical High $50.12 | Professional | None | $13.80 | $50.12 | $50.12 |
Pacific Source Setting Facility Modifier None Typical Low $15.14 Median $16.22 Typical High $18.62 | Facility | None | $15.14 | $16.22 | $18.62 |
Providence Setting Facility Modifier None Typical Low $13.49 Median $51.29 Typical High $102.33 | Facility | None | $13.49 | $51.29 | $102.33 |
Providence Setting Professional Modifier None Typical Low $11.22 Median $52.48 Typical High $79.43 | Professional | None | $11.22 | $52.48 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $10.47 Median $17.78 Typical High $83.18 | Facility | None | $10.47 | $17.78 | $83.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $33.11 | Professional | None | $30.90 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $57.54 | Professional | None | $50.12 | $50.12 | $57.54 |
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 $25.12 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.01 |
Where Oregon sits
The same service costs 6.6 times more in Alaska than in Hawaii. 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· 32nd of 51
$50.12
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.