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 $16.98 Median $24.55 Typical High $24.55 | Professional | None | $16.98 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $151.36 | Professional | None | $54.95 | $64.57 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $24.55 Median $32.36 Typical High $34.67 | Facility | None | $24.55 | $32.36 | $34.67 |
Moda Health Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $33.88 | Professional | None | $24.55 | $30.90 | $33.88 |
Pacific Source Setting Facility Modifier None Typical Low $30.20 Median $32.36 Typical High $33.11 | Facility | None | $30.20 | $32.36 | $33.11 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $28.84 Typical High $40.74 | Facility | None | $28.18 | $28.84 | $40.74 |
Providence Setting Professional Modifier None Typical Low $13.80 Median $27.54 Typical High $79.43 | Professional | None | $13.80 | $27.54 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $35.48 Median $37.15 Typical High $37.15 | Professional | None | $35.48 | $37.15 | $37.15 |
United Setting Professional Modifier None Typical Low $10.96 Median $14.13 Typical High $26.92 | Professional | None | $10.96 | $14.13 | $26.92 |
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 $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 54 · Surgery only | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.90 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 54 · Surgery only | $18.20 | $18.20 | $18.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $3.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Where Oregon sits
The same service costs 2.6 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· 22nd of 51
$24.55
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.