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 $20.89 Median $23.99 Typical High $23.99 | Professional | None | $20.89 | $23.99 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $87.10 | Professional | None | $63.10 | $74.13 | $87.10 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $25.12 Typical High $79.43 | Facility | None | $15.14 | $25.12 | $79.43 |
Moda Health Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Pacific Source Setting Facility Modifier None Typical Low $48.98 Median $58.88 Typical High $93.33 | Facility | None | $48.98 | $58.88 | $93.33 |
Pacific Source Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $54.95 Typical High $79.43 | Facility | None | $20.42 | $54.95 | $79.43 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $87.10 | Professional | None | $39.81 | $39.81 | $87.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $54.95 Median $81.28 Typical High $123.03 | Facility | None | $54.95 | $81.28 | $123.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $83.18 | Professional | None | $63.10 | $70.79 | $83.18 |
United Setting Professional Modifier None Typical Low $17.38 Median $19.50 Typical High $32.36 | Professional | None | $17.38 | $19.50 | $32.36 |
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 $10.47 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $10.47 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $4.17 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.63 Typical High $3.63 | Professional | 55 · Aftercare only | $3.16 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.40 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.09 | $2.40 | $2.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $12.02 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $4.79 | $4.79 | $4.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $3.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $2.40 |
Where Oregon sits
The same service costs 8.9 times more in North Dakota than in Colorado. 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· 16th of 51
$39.81
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.