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 $19.05 Median $20.42 Typical High $20.42 | Professional | None | $19.05 | $20.42 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.18 Median $72.44 Typical High $91.20 | Professional | None | $28.18 | $72.44 | $91.20 |
Moda Health Setting Facility Modifier None Typical Low $20.42 Median $26.92 Typical High $34.67 | Facility | None | $20.42 | $26.92 | $34.67 |
Moda Health Setting Professional Modifier None Typical Low $20.42 Median $31.62 Typical High $35.48 | Professional | None | $20.42 | $31.62 | $35.48 |
Pacific Source Setting Facility Modifier None Typical Low $27.54 Median $33.88 Typical High $35.48 | Facility | None | $27.54 | $33.88 | $35.48 |
Providence Setting Facility Modifier None Typical Low $21.38 Median $24.55 Typical High $35.48 | Facility | None | $21.38 | $24.55 | $35.48 |
Providence Setting Professional Modifier None Typical Low $17.78 Median $28.84 Typical High $79.43 | Professional | None | $17.78 | $28.84 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $27.54 Median $54.95 Typical High $131.83 | Facility | None | $27.54 | $54.95 | $131.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $38.90 | Professional | None | $35.48 | $38.90 | $38.90 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $69.18 | Facility | None | $51.29 | $51.29 | $69.18 |
United Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $30.90 | Professional | None | $14.13 | $15.85 | $30.90 |
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 $9.33 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $9.33 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $3.80 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $2.82 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.91 | $2.04 | $2.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $4.07 | $4.17 | $4.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $3.02 | $3.09 | $3.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.04 |
Where Oregon sits
The same service costs 2.1 times more in Montana than in West Virginia. 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· 13th of 51
$29.51
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.