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 $40.74 Median $45.71 Typical High $45.71 | Professional | None | $40.74 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $158.49 Typical High $199.53 | Professional | None | $56.23 | $158.49 | $199.53 |
Moda Health Setting Facility Modifier None Typical Low $45.71 Median $64.57 Typical High $75.86 | Facility | None | $45.71 | $64.57 | $75.86 |
Moda Health Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $75.86 | Professional | None | $45.71 | $69.18 | $75.86 |
Pacific Source Setting Facility Modifier None Typical Low $67.61 Median $74.13 Typical High $77.62 | Facility | None | $67.61 | $74.13 | $77.62 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $45.71 Typical High $75.86 | Facility | None | $43.65 | $45.71 | $75.86 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $63.10 Typical High $79.43 | Professional | None | $37.15 | $63.10 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $60.26 Median $117.49 Typical High $288.40 | Facility | None | $60.26 | $117.49 | $288.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | None | $77.62 | $83.18 | $83.18 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $147.91 | Facility | None | $112.20 | $112.20 | $147.91 |
United Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $66.07 | Professional | None | $31.62 | $33.88 | $66.07 |
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 $6.17 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $6.17 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.07 | $4.47 | $4.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $6.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $4.57 |
Where Oregon sits
The same service costs 2.2 times more in Montana than in West Virginia. 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
$64.57
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.