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 $23.99 Median $31.62 Typical High $31.62 | Professional | None | $23.99 | $31.62 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $151.36 | Professional | None | $70.79 | $83.18 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $31.62 Median $41.69 Typical High $44.67 | Facility | None | $31.62 | $41.69 | $44.67 |
Moda Health Setting Professional Modifier None Typical Low $31.62 Median $39.81 Typical High $43.65 | Professional | None | $31.62 | $39.81 | $43.65 |
Pacific Source Setting Facility Modifier None Typical Low $38.02 Median $41.69 Typical High $42.66 | Facility | None | $38.02 | $41.69 | $42.66 |
Providence Setting Facility Modifier None Typical Low $36.31 Median $37.15 Typical High $52.48 | Facility | None | $36.31 | $37.15 | $52.48 |
Providence Setting Professional Modifier None Typical Low $17.78 Median $35.48 Typical High $79.43 | Professional | None | $17.78 | $35.48 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | None | $45.71 | $47.86 | $47.86 |
United Setting Professional Modifier None Typical Low $14.13 Median $18.20 Typical High $35.48 | Professional | None | $14.13 | $18.20 | $35.48 |
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 $15.85 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.31 |
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 $3.16 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.16 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.85 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.31 |
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 $3.16 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.16 |
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· 23rd of 51
$31.62
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.