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 $81.28 Median $89.13 Typical High $89.13 | Professional | None | $81.28 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $316.23 Typical High $389.05 | Professional | None | $112.20 | $316.23 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $128.82 Typical High $151.36 | Facility | None | $89.13 | $128.82 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $151.36 | Professional | None | $89.13 | $138.04 | $151.36 |
Pacific Source Setting Facility Modifier None Typical Low $117.49 Median $144.54 Typical High $151.36 | Facility | None | $117.49 | $144.54 | $151.36 |
Pacific Source Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Providence Setting Facility Modifier None Typical Low $91.20 Median $97.72 Typical High $151.36 | Facility | None | $91.20 | $97.72 | $151.36 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $144.54 | Professional | None | $72.44 | $79.43 | $144.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $120.23 Median $234.42 Typical High $575.44 | Facility | None | $120.23 | $234.42 | $575.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | None | $151.36 | $165.96 | $165.96 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $295.12 | Facility | None | $218.78 | $218.78 | $295.12 |
United Setting Professional Modifier None Typical Low $63.10 Median $67.61 Typical High $131.83 | Professional | None | $63.10 | $67.61 | $131.83 |
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 $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $12.30 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.13 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $8.91 |
Where Oregon sits
The same service costs 4.2 times more in Kansas 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
$117
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.