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 $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $151.36 | Professional | None | $56.23 | $66.07 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $32.36 Typical High $35.48 | Facility | None | $25.12 | $32.36 | $35.48 |
Moda Health Setting Professional Modifier None Typical Low $25.12 Median $30.90 Typical High $33.88 | Professional | None | $25.12 | $30.90 | $33.88 |
Pacific Source Setting Facility Modifier None Typical Low $30.20 Median $33.11 Typical High $33.88 | Facility | None | $30.20 | $33.11 | $33.88 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $29.51 Typical High $41.69 | Facility | None | $28.84 | $29.51 | $41.69 |
Providence Setting Professional Modifier None Typical Low $14.13 Median $27.54 Typical High $79.43 | Professional | None | $14.13 | $27.54 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $38.02 | Professional | None | $36.31 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $11.22 Median $14.13 Typical High $28.18 | Professional | None | $11.22 | $14.13 | $28.18 |
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 $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 54 · Surgery only | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.51 |
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 $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 54 · Surgery only | $18.62 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.51 |
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
$25.12
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.