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 $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
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 $34.67 Typical High $38.02 | Facility | None | $26.92 | $34.67 | $38.02 |
Moda Health Setting Professional Modifier None Typical Low $26.92 Median $33.11 Typical High $36.31 | Professional | None | $26.92 | $33.11 | $36.31 |
Pacific Source Setting Facility Modifier None Typical Low $32.36 Median $35.48 Typical High $36.31 | Facility | None | $32.36 | $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 $29.51 Typical High $79.43 | Professional | None | $15.14 | $29.51 | $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 $15.14 Typical High $30.20 | Professional | None | $12.02 | $15.14 | $30.20 |
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 $13.18 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $13.18 | $13.18 | $13.18 |
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 $19.95 Median $19.95 Typical High $19.95 | Professional | 54 · Surgery only | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $3.98 |
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 $13.18 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $13.18 | $13.18 | $13.18 |
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 $19.95 Median $19.95 Typical High $19.95 | Professional | 54 · Surgery only | $19.95 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $3.98 |
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 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
$26.92
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.