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 $204.17 Median $223.87 Typical High $223.87 | Professional | None | $204.17 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | None | $257.04 | $257.04 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $794.33 Typical High $1,000.00 | Professional | None | $281.84 | $794.33 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $281.84 Typical High $380.19 | Facility | None | $223.87 | $281.84 | $380.19 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $380.19 | Professional | None | $223.87 | $338.84 | $380.19 |
Pacific Source Setting Facility Modifier None Typical Low $331.13 Median $363.08 Typical High $371.54 | Facility | None | $331.13 | $363.08 | $371.54 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $302.00 Typical High $371.54 | Facility | None | $223.87 | $302.00 | $371.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $257.04 Typical High $363.08 | Professional | None | $79.43 | $257.04 | $363.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | None | $380.19 | $416.87 | $416.87 |
United Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $331.13 | Professional | None | $158.49 | $169.82 | $331.13 |
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 $102.33 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $102.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $40.74 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.42 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $44.67 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
Where Oregon sits
The same service costs 3.0 times more in Iowa 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· 12th of 51
$302
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.