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 $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $223.87 Typical High $302.00 | Facility | None | $141.25 | $223.87 | $302.00 |
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 $44.67 Median $58.88 Typical High $63.10 | Facility | None | $44.67 | $58.88 | $63.10 |
Moda Health Setting Professional Modifier None Typical Low $44.67 Median $141.25 Typical High $281.84 | Professional | None | $44.67 | $141.25 | $281.84 |
Providence Setting Facility Modifier None Typical Low $91.20 Median $208.93 Typical High $288.40 | Facility | None | $91.20 | $208.93 | $288.40 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $125.89 Typical High $125.89 | Professional | None | $37.15 | $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 |
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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 54 · Surgery only | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $4.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $8.91 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 54 · Surgery only | $33.11 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $4.47 |
Where Oregon sits
The same service costs 6.3 times more in North Dakota than in Hawaii. 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· 5th 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.