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 $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $27.54 Median $32.36 Typical High $151.36 | Professional | None | $27.54 | $32.36 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $12.30 Median $16.22 Typical High $17.78 | Facility | None | $12.30 | $16.22 | $17.78 |
Moda Health Setting Professional Modifier None Typical Low $12.30 Median $15.49 Typical High $16.98 | Professional | None | $12.30 | $15.49 | $16.98 |
Pacific Source Setting Facility Modifier None Typical Low $15.14 Median $16.60 Typical High $16.98 | Facility | None | $15.14 | $16.60 | $16.98 |
Providence Setting Facility Modifier None Typical Low $14.45 Median $14.79 Typical High $20.42 | Facility | None | $14.45 | $14.79 | $20.42 |
Providence Setting Professional Modifier None Typical Low $7.08 Median $13.80 Typical High $79.43 | Professional | None | $7.08 | $13.80 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $17.78 Median $19.05 Typical High $19.05 | Professional | None | $17.78 | $19.05 | $19.05 |
United Setting Professional Modifier None Typical Low $5.62 Median $7.08 Typical High $14.13 | Professional | None | $5.62 | $7.08 | $14.13 |
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 $6.17 Median $6.17 Typical High $6.17 | Professional | 52 · Reduced service | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 53 · Discontinued | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 54 · Surgery only | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 52 · Reduced service | $6.17 | $6.17 | $6.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 53 · Discontinued | $2.51 | $2.51 | $2.51 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 54 · Surgery only | $9.33 | $9.33 | $9.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $1.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.23 |
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· 22nd of 51
$12.30
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.