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 $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $151.36 | Professional | None | $38.90 | $45.71 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $17.38 Median $22.91 Typical High $25.12 | Facility | None | $17.38 | $22.91 | $25.12 |
Moda Health Setting Professional Modifier None Typical Low $17.38 Median $21.88 Typical High $23.44 | Professional | None | $17.38 | $21.88 | $23.44 |
Pacific Source Setting Facility Modifier None Typical Low $21.38 Median $22.91 Typical High $23.44 | Facility | None | $21.38 | $22.91 | $23.44 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $20.89 Typical High $28.84 | Facility | None | $20.42 | $20.89 | $28.84 |
Providence Setting Professional Modifier None Typical Low $9.77 Median $19.50 Typical High $79.43 | Professional | None | $9.77 | $19.50 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.12 Median $26.30 Typical High $26.30 | Professional | None | $25.12 | $26.30 | $26.30 |
United Setting Professional Modifier None Typical Low $7.76 Median $10.00 Typical High $19.50 | Professional | None | $7.76 | $10.00 | $19.50 |
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 $8.71 Median $8.71 Typical High $8.71 | Professional | 52 · Reduced service | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 54 · Surgery only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 55 · Aftercare only | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 52 · Reduced service | $8.71 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.47 | $3.47 | $3.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 54 · Surgery only | $13.18 | $13.18 | $13.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 55 · Aftercare only | $2.63 | $2.63 | $2.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.74 |
Where Oregon sits
The same service costs 3.2 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· 23rd of 51
$17.38
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.