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 $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $223.87 Typical High $295.12 | Facility | None | $18.20 | $223.87 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $346.74 | Professional | None | $177.83 | $275.42 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $2.51 Median $3.55 Typical High $16.60 | Facility | None | $2.51 | $3.55 | $16.60 |
Moda Health Setting Professional Modifier None Typical Low $2.51 Median $141.25 Typical High $275.42 | Professional | None | $2.51 | $141.25 | $275.42 |
Pacific Source Setting Facility Modifier None Typical Low $2.45 Median $2.51 Typical High $7.76 | Facility | None | $2.45 | $2.51 | $7.76 |
Providence Setting Facility Modifier None Typical Low $16.60 Median $208.93 Typical High $288.40 | Facility | None | $16.60 | $208.93 | $288.40 |
Providence Setting Professional Modifier None Typical Low $12.88 Median $125.89 Typical High $125.89 | Professional | None | $12.88 | $125.89 | $125.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $218.78 | Professional | None | $125.89 | $204.17 | $218.78 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
8 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 $1.26 Median $1.26 Typical High $1.26 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $0.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $0.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.25 |
Where Oregon sits
The same service costs 50.1 times more in Massachusetts than in Indiana. 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· 6th of 51
$126
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.