How much rates vary
Facilitymedian $4 · 10th to 90th $3 to $4Professionalmedian $3 · 10th to 90th $2 to $5
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 $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.03 Median $8.13 Typical High $151.36 | Professional | None | $6.03 | $8.13 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $3.24 Median $3.80 Typical High $4.57 | Facility | None | $3.24 | $3.80 | $4.57 |
Moda Health Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $4.37 | Professional | None | $3.24 | $3.47 | $4.37 |
Moda Health Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $3.47 Typical High $4.37 | Professional | AU · Urologic/ostomy supply | $1.20 | $3.47 | $4.37 |
Pacific Source Setting Facility Modifier None Typical Low $3.47 Median $3.80 Typical High $4.37 | Facility | None | $3.47 | $3.80 | $4.37 |
Pacific Source Setting Professional Modifier None Typical Low $3.72 Median $4.79 Typical High $5.62 | Professional | None | $3.72 | $4.79 | $5.62 |
Providence Setting Facility Modifier None Typical Low $3.39 Median $3.80 Typical High $5.37 | Facility | None | $3.39 | $3.80 | $5.37 |
Providence Setting Professional Modifier None Typical Low $2.14 Median $2.24 Typical High $79.43 | Professional | None | $2.14 | $2.24 | $79.43 |
Providence Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $2.14 Median $2.14 Typical High $2.29 | Professional | AU · Urologic/ostomy supply | $2.14 | $2.14 | $2.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.68 Median $4.90 Typical High $4.90 | Professional | None | $4.68 | $4.90 | $4.90 |
Regence BlueShield Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $4.68 Median $4.90 Typical High $4.90 | Professional | AU · Urologic/ostomy supply | $4.68 | $4.90 | $4.90 |
United Setting Professional Modifier None Typical Low $1.45 Median $1.86 Typical High $3.55 | Professional | None | $1.45 | $1.86 | $3.55 |
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 $1.62 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | 55 · Aftercare only | $0.48 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | 55 · Aftercare only | $0.48 | $0.48 | $0.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.32 |
Where Oregon sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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
$3.24
MN $5.25NH $1.20
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.