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 $10.00 Median $13.18 Typical High $13.18 | Professional | None | $10.00 | $13.18 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $151.36 | Professional | None | $28.84 | $33.88 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $13.18 Median $17.38 Typical High $19.05 | Facility | None | $13.18 | $17.38 | $19.05 |
Moda Health Setting Professional Modifier None Typical Low $13.18 Median $16.60 Typical High $18.20 | Professional | None | $13.18 | $16.60 | $18.20 |
Pacific Source Setting Facility Modifier None Typical Low $16.22 Median $17.78 Typical High $18.20 | Facility | None | $16.22 | $17.78 | $18.20 |
Providence Setting Facility Modifier None Typical Low $15.49 Median $15.85 Typical High $21.88 | Facility | None | $15.49 | $15.85 | $21.88 |
Providence Setting Professional Modifier None Typical Low $7.59 Median $14.79 Typical High $79.43 | Professional | None | $7.59 | $14.79 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $19.05 Median $20.42 Typical High $20.42 | Professional | None | $19.05 | $20.42 | $20.42 |
United Setting Professional Modifier None Typical Low $6.03 Median $7.59 Typical High $14.79 | Professional | None | $6.03 | $7.59 | $14.79 |
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 $6.61 Median $6.61 Typical High $6.61 | Professional | 52 · Reduced service | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 53 · Discontinued | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 54 · Surgery only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 52 · Reduced service | $6.61 | $6.61 | $6.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 53 · Discontinued | $2.63 | $2.63 | $2.63 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 54 · Surgery only | $10.00 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.32 |
Where Oregon sits
The same service costs 2.7 times more in Idaho 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
$13.18
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.