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 $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $229.09 Typical High $295.12 | Facility | None | $169.82 | $229.09 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $128.82 | Professional | None | $125.89 | $125.89 | $128.82 |
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 $123.03 Median $177.83 Typical High $295.12 | Facility | None | $123.03 | $177.83 | $295.12 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $281.84 | Professional | None | $123.03 | $141.25 | $281.84 |
Pacific Source Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $229.09 | Facility | None | $123.03 | $125.89 | $229.09 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $295.12 | Facility | None | $165.96 | $229.09 | $295.12 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $158.49 | Professional | None | $79.43 | $125.89 | $158.49 |
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 $61.66 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $61.66 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $24.55 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
Where Oregon sits
The same service costs 1.9 times more in Wyoming than in North Carolina. 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· 37th 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.