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 $46.77 Median $52.48 Typical High $52.48 | Professional | None | $46.77 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $66.07 | Professional | None | $58.88 | $58.88 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $181.97 Typical High $229.09 | Professional | None | $66.07 | $181.97 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $52.48 Median $74.13 Typical High $87.10 | Facility | None | $52.48 | $74.13 | $87.10 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $87.10 | Professional | None | $52.48 | $79.43 | $87.10 |
Pacific Source Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $89.13 | Facility | None | $83.18 | $85.11 | $89.13 |
Providence Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $87.10 | Facility | None | $52.48 | $69.18 | $87.10 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $83.18 | Professional | None | $58.88 | $70.79 | $83.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $69.18 Median $134.90 Typical High $331.13 | Facility | None | $69.18 | $134.90 | $331.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $95.50 | Professional | None | $89.13 | $95.50 | $95.50 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $169.82 | Facility | None | $128.82 | $128.82 | $169.82 |
United Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $75.86 | Professional | None | $36.31 | $38.90 | $75.86 |
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 $23.44 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $23.44 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $9.33 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.08 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.68 | $5.25 | $5.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $26.30 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.47 | $10.47 | $10.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.25 |
Where Oregon sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 10th of 51
$75.86
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.