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 $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.50 Median $7.41 Typical High $151.36 | Professional | None | $5.50 | $7.41 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $2.51 Median $3.31 Typical High $3.63 | Facility | None | $2.51 | $3.31 | $3.63 |
Moda Health Setting Professional Modifier None Typical Low $2.51 Median $3.31 Typical High $3.39 | Professional | None | $2.51 | $3.31 | $3.39 |
Pacific Source Setting Facility Modifier None Typical Low $2.88 Median $3.39 Typical High $3.63 | Facility | None | $2.88 | $3.39 | $3.63 |
Pacific Source Setting Professional Modifier None Typical Low $2.88 Median $3.02 Typical High $3.39 | Professional | None | $2.88 | $3.02 | $3.39 |
Providence Setting Facility Modifier None Typical Low $2.88 Median $3.24 Typical High $12.88 | Facility | None | $2.88 | $3.24 | $12.88 |
Providence Setting Professional Modifier None Typical Low $2.00 Median $2.69 Typical High $79.43 | Professional | None | $2.00 | $2.69 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.98 | Professional | None | $3.80 | $3.80 | $3.98 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.70 Typical High $3.24 | Professional | None | $1.32 | $1.70 | $3.24 |
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 $1.26 Median $1.26 Typical High $1.26 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | 55 · Aftercare only | $0.38 | $0.38 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | 55 · Aftercare only | $0.38 | $0.38 | $0.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.25 |
Where Oregon sits
The same service costs 2.3 times more in Hawaii 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· 21st of 51
$2.51
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.