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 $20.89 Median $20.89 Typical High $21.38 | Professional | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $37.15 Typical High $57.54 | Facility | None | $27.54 | $37.15 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $24.55 | Professional | None | $20.89 | $20.89 | $24.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $61.66 Typical High $75.86 | Professional | None | $41.69 | $61.66 | $75.86 |
Moda Health Setting Facility Modifier None Typical Low $20.89 Median $22.39 Typical High $52.48 | Facility | None | $20.89 | $22.39 | $52.48 |
Moda Health Setting Professional Modifier None Typical Low $20.89 Median $23.99 Typical High $29.51 | Professional | None | $20.89 | $23.99 | $29.51 |
Pacific Source Setting Facility Modifier None Typical Low $18.62 Median $23.99 Typical High $57.54 | Facility | None | $18.62 | $23.99 | $57.54 |
Providence Setting Facility Modifier None Typical Low $23.44 Median $26.30 Typical High $57.54 | Facility | None | $23.44 | $26.30 | $57.54 |
Providence Setting Professional Modifier None Typical Low $20.89 Median $26.30 Typical High $79.43 | Professional | None | $20.89 | $26.30 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $42.66 Median $104.71 Typical High $134.90 | Facility | None | $42.66 | $104.71 | $134.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $19.50 Median $20.89 Typical High $20.89 | Professional | None | $19.50 | $20.89 | $20.89 |
United Setting Facility Modifier None Typical Low $20.89 Median $42.66 Typical High $50.12 | Facility | None | $20.89 | $42.66 | $50.12 |
United Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $34.67 | Professional | None | $29.51 | $29.51 | $34.67 |
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 $10.47 Median $10.47 Typical High $10.72 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.27 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.79 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $6.03 | $6.03 | $6.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $2.95 |
Where Oregon sits
The same service costs 3.8 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· 31st of 51
$22.39
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.