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 $100.00 Median $131.83 Typical High $131.83 | Professional | None | $100.00 | $131.83 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $269.15 | Professional | None | $173.78 | $208.93 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $186.21 Typical High $245.47 | Facility | None | $131.83 | $186.21 | $245.47 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | None | $125.89 | $131.83 | $131.83 |
Pacific Source Setting Facility Modifier None Typical Low $154.88 Median $186.21 Typical High $190.55 | Facility | None | $154.88 | $186.21 | $190.55 |
Providence Setting Facility Modifier None Typical Low $138.04 Median $199.53 Typical High $245.47 | Facility | None | $138.04 | $199.53 | $245.47 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $275.42 | Professional | None | $77.62 | $81.28 | $275.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $239.88 | Professional | None | $151.36 | $162.18 | $239.88 |
United Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $288.40 | Professional | None | $141.25 | $177.83 | $288.40 |
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 $50.12 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $50.12 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $19.95 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $15.14 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.00 | $13.18 | $13.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $63.10 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $25.12 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $19.05 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $13.18 |
Where Oregon sits
The same service costs 3.3 times more in Alaska than in Wyoming. 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
$132
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.