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 $64.57 Median $67.61 Typical High $67.61 | Professional | None | $64.57 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $239.88 Typical High $302.00 | Professional | None | $87.10 | $239.88 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $97.72 Typical High $114.82 | Facility | None | $67.61 | $97.72 | $114.82 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | None | $66.07 | $67.61 | $67.61 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $112.20 Typical High $117.49 | Facility | None | $109.65 | $112.20 | $117.49 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $114.82 | Facility | None | $70.79 | $70.79 | $114.82 |
Providence Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $109.65 | Professional | None | $51.29 | $79.43 | $109.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $436.52 | Facility | None | $91.20 | $177.83 | $436.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | None | $117.49 | $125.89 | $125.89 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $223.87 | Facility | None | $169.82 | $169.82 | $223.87 |
United Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $100.00 | Professional | None | $48.98 | $51.29 | $100.00 |
6 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 $32.36 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $32.36 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.77 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $6.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.11 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.61 | $6.76 | $6.76 |
Where Oregon sits
The same service costs 2.4 times more in Montana than in Delaware. 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
$81.28
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.