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 $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $151.36 | Professional | None | $72.44 | $85.11 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $32.36 Median $42.66 Typical High $46.77 | Facility | None | $32.36 | $42.66 | $46.77 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $43.65 | Professional | None | $32.36 | $40.74 | $43.65 |
Pacific Source Setting Facility Modifier None Typical Low $39.81 Median $42.66 Typical High $43.65 | Facility | None | $39.81 | $42.66 | $43.65 |
Providence Setting Facility Modifier None Typical Low $38.02 Median $38.90 Typical High $53.70 | Facility | None | $38.02 | $38.90 | $53.70 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $36.31 Typical High $79.43 | Professional | None | $18.20 | $36.31 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | None | $46.77 | $48.98 | $48.98 |
United Setting Professional Modifier None Typical Low $14.45 Median $18.62 Typical High $36.31 | Professional | None | $14.45 | $18.62 | $36.31 |
10 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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 54 · Surgery only | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 54 · Surgery only | $24.55 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Where Oregon sits
The same service costs 2.7 times more in Hawaii 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· 21st of 51
$32.36
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.