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 $302.00 Median $371.54 Typical High $371.54 | Professional | None | $302.00 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None | $251.19 | $251.19 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $1,174.90 Typical High $1,445.44 | Professional | None | $467.74 | $1,174.90 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $467.74 Typical High $630.96 | Facility | None | $323.59 | $467.74 | $630.96 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $630.96 | Professional | None | $371.54 | $575.44 | $630.96 |
Pacific Source Setting Facility Modifier None Typical Low $489.78 Median $549.54 Typical High $616.60 | Facility | None | $489.78 | $549.54 | $616.60 |
Pacific Source Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $380.19 Typical High $630.96 | Facility | None | $323.59 | $380.19 | $630.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $251.19 Typical High $602.56 | Professional | None | $79.43 | $251.19 | $602.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $2,398.83 | Facility | None | $501.19 | $977.24 | $2,398.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $691.83 | Professional | None | $630.96 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $1,096.48 | Facility | None | $812.83 | $812.83 | $1,096.48 |
United Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $489.78 | Professional | None | $229.09 | $251.19 | $489.78 |
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 $151.36 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $151.36 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $60.26 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $44.67 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.20 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $186.21 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $75.86 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Where Oregon sits
The same service costs 2.9 times more in Iowa than in Kansas. 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· 8th of 51
$490
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.