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 $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $295.12 | Facility | None | $144.54 | $223.87 | $295.12 |
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 $173.78 Median $275.42 Typical High $346.74 | Professional | None | $173.78 | $275.42 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $141.25 Typical High $229.09 | Facility | None | $97.72 | $141.25 | $229.09 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $281.84 | Professional | None | $97.72 | $141.25 | $281.84 |
Pacific Source Setting Facility Modifier None Typical Low $89.13 Median $97.72 Typical High $147.91 | Facility | None | $89.13 | $97.72 | $147.91 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $218.78 Typical High $295.12 | Facility | None | $144.54 | $218.78 | $295.12 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $177.83 | Professional | None | $79.43 | $125.89 | $177.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $302.00 | Facility | None | $120.23 | $147.91 | $302.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $125.89 | Professional | None | $109.65 | $120.23 | $125.89 |
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 $48.98 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $9.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $48.98 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $19.50 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $9.77 |
Where Oregon sits
The same service costs 2.0 times more in Alaska 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
$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.