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 $251.19 Median $338.84 Typical High $338.84 | Professional | None | $251.19 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $354.81 | Professional | None | $316.23 | $316.23 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $977.24 Typical High $1,230.27 | Professional | None | $426.58 | $977.24 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $426.58 Typical High $575.44 | Facility | None | $281.84 | $426.58 | $575.44 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $575.44 | Professional | None | $338.84 | $524.81 | $575.44 |
Pacific Source Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $562.34 | Facility | None | $501.19 | $549.54 | $562.34 |
Providence Setting Facility Modifier None Typical Low $281.84 Median $371.54 Typical High $562.34 | Facility | None | $281.84 | $371.54 | $562.34 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $316.23 Typical High $549.54 | Professional | None | $79.43 | $316.23 | $549.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | None | $575.44 | $630.96 | $630.96 |
United Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $407.38 | Professional | None | $194.98 | $208.93 | $407.38 |
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 $125.89 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $50.12 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $38.02 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $25.12 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
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· 8th of 51
$417
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.