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 $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $251.19 | Professional | None | $199.53 | $199.53 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $912.01 Typical High $1,174.90 | Professional | None | $309.03 | $912.01 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $354.81 Typical High $416.87 | Facility | None | $245.47 | $354.81 | $416.87 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $416.87 | Professional | None | $245.47 | $371.54 | $416.87 |
Pacific Source Setting Facility Modifier None Typical Low $363.08 Median $407.38 Typical High $524.81 | Facility | None | $363.08 | $407.38 | $524.81 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $251.19 Typical High $407.38 | Facility | None | $245.47 | $251.19 | $407.38 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $398.11 | Professional | None | $79.43 | $199.53 | $398.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $457.09 | Professional | None | $416.87 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $398.11 | Professional | None | $186.21 | $199.53 | $398.11 |
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 $120.23 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $120.23 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Where Oregon sits
The same service costs 3.4 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
$324
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.