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 $26.92 Median $26.92 Typical High $60.26 | Professional | None | $26.92 | $26.92 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $151.36 | Professional | None | $60.26 | $70.79 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $26.92 Median $35.48 Typical High $38.90 | Facility | None | $26.92 | $35.48 | $38.90 |
Moda Health Setting Professional Modifier None Typical Low $26.92 Median $35.48 Typical High $60.26 | Professional | None | $26.92 | $35.48 | $60.26 |
Pacific Source Setting Facility Modifier None Typical Low $33.11 Median $35.48 Typical High $36.31 | Facility | None | $33.11 | $35.48 | $36.31 |
Providence Setting Facility Modifier None Typical Low $30.90 Median $31.62 Typical High $44.67 | Facility | None | $30.90 | $31.62 | $44.67 |
Providence Setting Professional Modifier None Typical Low $15.14 Median $30.20 Typical High $79.43 | Professional | None | $15.14 | $30.20 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | None | $38.90 | $40.74 | $40.74 |
United Setting Professional Modifier None Typical Low $12.02 Median $15.49 Typical High $29.51 | Professional | None | $12.02 | $15.49 | $29.51 |
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 $13.49 Median $13.49 Typical High $13.49 | Professional | 52 · Reduced service | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 54 · Surgery only | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $2.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 52 · Reduced service | $13.49 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $5.37 | $5.37 | $5.37 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 54 · Surgery only | $20.42 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $4.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $2.69 |
Where Oregon sits
The same service costs 3.1 times more in Rhode Island 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· 20th of 51
$30.20
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.