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 $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $223.87 Typical High $295.12 | Facility | None | $141.25 | $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 $107.15 Median $151.36 Typical High $758.58 | Facility | None | $107.15 | $151.36 | $758.58 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $281.84 | Professional | None | $107.15 | $141.25 | $281.84 |
Pacific Source Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $223.87 | Facility | None | $89.13 | $107.15 | $223.87 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $316.23 | Facility | None | $125.89 | $223.87 | $316.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $416.87 | Professional | None | $79.43 | $125.89 | $416.87 |
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 $53.70 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $53.70 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.72 |
Where Oregon sits
The same service costs 6.0 times more in Wyoming than in Montana. 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· 15th 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.