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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $162.18 | Professional | None | $141.25 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $549.54 Typical High $691.83 | Professional | None | $204.17 | $549.54 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $2,398.83 | Facility | None | $162.18 | $218.78 | $2,398.83 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $275.42 | Professional | None | $162.18 | $245.47 | $275.42 |
Pacific Source Setting Facility Modifier None Typical Low $257.04 Median $263.03 Typical High $269.15 | Facility | None | $257.04 | $263.03 | $269.15 |
Providence Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $269.15 | Facility | None | $147.91 | $194.98 | $269.15 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $263.03 | Professional | None | $79.43 | $165.96 | $263.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | None | $275.42 | $302.00 | $302.00 |
United Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $234.42 | Professional | None | $109.65 | $117.49 | $234.42 |
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 $21.38 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $21.38 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $16.22 |
Where Oregon sits
The same service costs 2.6 times more in Montana than in New York. 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· 15th of 51
$209
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.