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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $1,778.28 Typical High $2,238.72 | Professional | None | $645.65 | $1,778.28 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $851.14 Typical High $1,949.84 | Facility | None | $645.65 | $851.14 | $1,949.84 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,445.44 | Professional | None | $660.69 | $851.14 | $1,445.44 |
Pacific Source Setting Facility Modifier None Typical Low $758.58 Median $851.14 Typical High $870.96 | Facility | None | $758.58 | $851.14 | $870.96 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $1,445.44 Typical High $1,949.84 | Facility | None | $478.63 | $1,445.44 | $1,949.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $407.38 Typical High $831.76 | Professional | None | $79.43 | $407.38 | $831.76 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | None | $870.96 | $954.99 | $954.99 |
United Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $758.58 | Professional | None | $363.08 | $389.05 | $758.58 |
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 $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $295.12 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
Where Oregon sits
The same service costs 3.2 times more in Michigan than in Ohio. 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· 18th of 51
$813
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.