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 $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $1,445.44 Typical High $1,862.09 | Facility | None | $169.82 | $1,445.44 | $1,862.09 |
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 $660.69 Median $933.25 Typical High $1,905.46 | Facility | None | $660.69 | $933.25 | $1,905.46 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $416.87 Typical High $660.69 | Professional | None | $141.25 | $416.87 | $660.69 |
Pacific Source Setting Facility Modifier None Typical Low $660.69 Median $724.44 Typical High $1,445.44 | Facility | None | $660.69 | $724.44 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $269.15 Typical High $1,905.46 | Facility | None | $117.49 | $269.15 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $2,137.96 | Professional | None | $79.43 | $125.89 | $2,137.96 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Where Oregon sits
The same service costs 12.6 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· 29th of 51
$204
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.