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 $87.10 Median $91.20 Typical High $91.20 | Professional | None | $87.10 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $323.59 Typical High $398.11 | Professional | None | $114.82 | $323.59 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $131.83 Typical High $154.88 | Facility | None | $91.20 | $131.83 | $154.88 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $154.88 | Professional | None | $91.20 | $138.04 | $154.88 |
Pacific Source Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $154.88 | Facility | None | $120.23 | $147.91 | $154.88 |
Pacific Source Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $100.00 Typical High $154.88 | Facility | None | $93.33 | $100.00 | $154.88 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $147.91 | Professional | None | $72.44 | $79.43 | $147.91 |
Regence BlueShield Setting Facility Modifier None Typical Low $120.23 Median $239.88 Typical High $588.84 | Facility | None | $120.23 | $239.88 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | None | $154.88 | $169.82 | $169.82 |
United Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $302.00 | Facility | None | $223.87 | $223.87 | $302.00 |
United Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $134.90 | Professional | None | $63.10 | $69.18 | $134.90 |
4 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 55 · Aftercare only Typical Low $12.30 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $12.30 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.32 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Where Oregon sits
The same service costs 2.2 times more in Montana than in Florida. 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
$120
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.