How much rates vary
Facilitymedian $9 · 10th to 90th $6 to $110Professionalmedian $6 · 10th to 90th $4 to $9
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 $7.08 Median $8.71 Typical High $10.72 | Facility | None | $7.08 | $8.71 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $3.09 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.62 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $5.01 | Professional | None | $3.02 | $3.98 | $5.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.41 Median $9.77 Typical High $12.88 | Professional | None | $7.41 | $9.77 | $12.88 |
Moda Health Setting Facility Modifier None Typical Low $6.17 Median $10.72 Typical High $100.00 | Facility | None | $6.17 | $10.72 | $100.00 |
Moda Health Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $9.12 | Professional | None | $6.17 | $6.17 | $9.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $3.09 | $3.09 | $3.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $1.23 | $1.23 | $1.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $0.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.62 |
Pacific Source Setting Facility Modifier None Typical Low $5.62 Median $9.12 Typical High $10.72 | Facility | None | $5.62 | $9.12 | $10.72 |
Providence Setting Facility Modifier None Typical Low $6.03 Median $8.71 Typical High $14.13 | Facility | None | $6.03 | $8.71 | $14.13 |
Providence Setting Professional Modifier None Typical Low $3.02 Median $5.37 Typical High $79.43 | Professional | None | $3.02 | $5.37 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $154.88 | Facility | None | $100.00 | $131.83 | $154.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.37 Median $5.62 Typical High $7.59 | Professional | None | $5.37 | $5.62 | $7.59 |
United Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $186.21 | Facility | None | $117.49 | $147.91 | $186.21 |
United Setting Professional Modifier None Typical Low $7.24 Median $9.77 Typical High $15.14 | Professional | None | $7.24 | $9.77 | $15.14 |
2 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 |
|---|---|---|---|---|---|
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $5.37 Median $9.77 Typical High $15.14 | Professional | 59 · Distinct service | $5.37 | $9.77 | $15.14 |
Moda Health Setting Professional Modifier X1 · Ongoing, broad care Typical Low $5.13 Median $10.23 Typical High $12.02 | Professional | X1 · Ongoing, broad care | $5.13 | $10.23 | $12.02 |
Where Oregon sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 12th of 51
$6.17
ND $8.71NM $3.24
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.