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 Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | None | $446.68 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,737.80 Typical High $2,187.76 | Professional | None | $676.08 | $1,737.80 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $691.83 Typical High $977.24 | Facility | None | $537.03 | $691.83 | $977.24 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $891.25 | Professional | None | $537.03 | $794.33 | $891.25 |
Pacific Source Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $1,000.00 | Facility | None | $851.14 | $870.96 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $660.69 Typical High $870.96 | Facility | None | $537.03 | $660.69 | $870.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $851.14 | Professional | None | $79.43 | $562.34 | $851.14 |
Regence BlueShield Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $977.24 | Professional | None | $912.01 | $977.24 | $977.24 |
United Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $724.44 | Professional | None | $346.74 | $371.54 | $724.44 |
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 $223.87 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $107.15 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
Where Oregon sits
The same service costs 2.5 times more in Montana than in Washington, DC. 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· 13th of 51
$692
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.