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 $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
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 $7.24 Median $8.91 Typical High $151.36 | Professional | None | $7.24 | $8.91 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $3.55 Median $4.17 Typical High $5.01 | Facility | None | $3.55 | $4.17 | $5.01 |
Moda Health Setting Professional Modifier None Typical Low $3.47 Median $3.80 Typical High $4.79 | Professional | None | $3.47 | $3.80 | $4.79 |
Pacific Source Setting Facility Modifier None Typical Low $3.80 Median $4.68 Typical High $4.79 | Facility | None | $3.80 | $4.68 | $4.79 |
Pacific Source Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Providence Setting Facility Modifier None Typical Low $4.07 Median $4.17 Typical High $5.89 | Facility | None | $4.07 | $4.17 | $5.89 |
Providence Setting Professional Modifier None Typical Low $2.00 Median $3.89 Typical High $79.43 | Professional | None | $2.00 | $3.89 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.13 Median $5.37 Typical High $5.37 | Professional | None | $5.13 | $5.37 | $5.37 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.04 Typical High $3.89 | Professional | None | $1.58 | $2.04 | $3.89 |
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 $1.74 Median $1.74 Typical High $1.74 | Professional | 52 · Reduced service | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.35 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 52 · Reduced service | $1.74 | $1.74 | $1.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.35 |
Where Oregon sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 20th of 51
$3.55
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.