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 Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $223.87 | Facility | None | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | None | $151.36 | $151.36 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $223.87 Typical High $316.23 | Facility | None | $169.82 | $223.87 | $316.23 |
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 $165.96 Median $288.40 Typical High $436.52 | Facility | None | $165.96 | $288.40 | $436.52 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $269.15 | Professional | None | $141.25 | $151.36 | $269.15 |
Pacific Source Setting Facility Modifier None Typical Low $151.36 Median $169.82 Typical High $316.23 | Facility | None | $151.36 | $169.82 | $316.23 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $223.87 Typical High $436.52 | Facility | None | $117.49 | $223.87 | $436.52 |
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 $239.88 Typical High $251.19 | Professional | None | $125.89 | $239.88 | $251.19 |
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 $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Where Oregon sits
The same service costs 2.9 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· 26th of 51
$151
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.