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 $20.42 Median $30.90 Typical High $30.90 | Professional | None | $20.42 | $30.90 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $151.36 | Professional | None | $69.18 | $81.28 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $40.74 Typical High $44.67 | Facility | None | $30.90 | $40.74 | $44.67 |
Moda Health Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $41.69 | Professional | None | $30.90 | $38.90 | $41.69 |
Pacific Source Setting Facility Modifier None Typical Low $38.02 Median $40.74 Typical High $41.69 | Facility | None | $38.02 | $40.74 | $41.69 |
Providence Setting Facility Modifier None Typical Low $35.48 Median $36.31 Typical High $51.29 | Facility | None | $35.48 | $36.31 | $51.29 |
Providence Setting Professional Modifier None Typical Low $17.38 Median $35.48 Typical High $79.43 | Professional | None | $17.38 | $35.48 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | None | $44.67 | $46.77 | $46.77 |
United Setting Professional Modifier None Typical Low $13.80 Median $17.78 Typical High $34.67 | Professional | None | $13.80 | $17.78 | $34.67 |
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 $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 54 · Surgery only | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 54 · Surgery only | $23.44 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
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
$30.90
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.