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 $95.50 Median $95.50 Typical High $107.15 | Facility | None | $95.50 | $95.50 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $24.55 Typical High $24.55 | Professional | None | $20.89 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $74.13 | Professional | None | $48.98 | $56.23 | $74.13 |
Moda Health Setting Facility Modifier None Typical Low $24.55 Median $61.66 Typical High $107.15 | Facility | None | $24.55 | $61.66 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $24.55 Median $30.20 Typical High $69.18 | Professional | None | $24.55 | $30.20 | $69.18 |
Pacific Source Setting Facility Modifier None Typical Low $27.54 Median $44.67 Typical High $52.48 | Facility | None | $27.54 | $44.67 | $52.48 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $64.57 Typical High $112.20 | Facility | None | $28.18 | $64.57 | $112.20 |
Providence Setting Professional Modifier None Typical Low $23.99 Median $47.86 Typical High $77.62 | Professional | None | $23.99 | $47.86 | $77.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $74.13 | Professional | None | $41.69 | $44.67 | $74.13 |
United Setting Professional Modifier None Typical Low $23.99 Median $45.71 Typical High $75.86 | Professional | None | $23.99 | $45.71 | $75.86 |
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 $10.47 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $10.47 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.17 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.16 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.09 | $2.45 | $2.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $11.75 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.68 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.47 | $3.72 | $3.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.34 | $2.45 | $2.45 |
Where Oregon sits
The same service costs 4.1 times more in Wyoming than in Kentucky. 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· 6th of 51
$43.65
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.