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 $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $269.15 Typical High $891.25 | Facility | None | $169.82 | $269.15 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | None | $125.89 | $125.89 | $138.04 |
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 $38.90 Median $56.23 Typical High $1,258.93 | Facility | None | $38.90 | $56.23 | $1,258.93 |
Moda Health Setting Professional Modifier None Typical Low $38.90 Median $141.25 Typical High $281.84 | Professional | None | $38.90 | $141.25 | $281.84 |
Pacific Source Setting Facility Modifier None Typical Low $38.90 Median $41.69 Typical High $74.13 | Facility | None | $38.90 | $41.69 | $74.13 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $269.15 Typical High $1,258.93 | Facility | None | $117.49 | $269.15 | $1,258.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $1,174.90 | Professional | None | $79.43 | $125.89 | $1,174.90 |
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 $19.50 Median $19.50 Typical High $19.50 | Professional | 52 · Reduced service | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $3.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 52 · Reduced service | $19.50 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.94 | $7.94 | $7.94 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $5.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $3.89 |
Where Oregon sits
The same service costs 25.1 times more in Wyoming than in Kentucky. 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· 27th 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.