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 $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $190.55 | Professional | None | $123.03 | $144.54 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $70.79 Typical High $77.62 | Facility | None | $54.95 | $70.79 | $77.62 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $74.13 | Professional | None | $54.95 | $69.18 | $74.13 |
Pacific Source Setting Facility Modifier None Typical Low $66.07 Median $72.44 Typical High $74.13 | Facility | None | $66.07 | $72.44 | $74.13 |
Providence Setting Facility Modifier None Typical Low $63.10 Median $64.57 Typical High $91.20 | Facility | None | $63.10 | $64.57 | $91.20 |
Providence Setting Professional Modifier None Typical Low $30.90 Median $60.26 Typical High $79.43 | Professional | None | $30.90 | $60.26 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | None | $79.43 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $24.55 Median $31.62 Typical High $61.66 | Professional | None | $24.55 | $31.62 | $61.66 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 54 · Surgery only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.96 | $10.96 | $10.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 54 · Surgery only | $40.74 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
Where Oregon sits
The same service costs 2.8 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
$54.95
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.