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 $5.89 Median $12.88 Typical High $12.88 | Professional | None | $5.89 | $12.88 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | None | $10.47 | $10.47 | $12.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.49 Median $40.74 Typical High $48.98 | Professional | None | $13.49 | $40.74 | $48.98 |
Moda Health Setting Facility Modifier None Typical Low $12.59 Median $13.18 Typical High $18.62 | Facility | None | $12.59 | $13.18 | $18.62 |
Moda Health Setting Professional Modifier None Typical Low $12.88 Median $16.22 Typical High $17.78 | Professional | None | $12.88 | $16.22 | $17.78 |
Pacific Source Setting Facility Modifier None Typical Low $14.13 Median $17.38 Typical High $20.89 | Facility | None | $14.13 | $17.38 | $20.89 |
Pacific Source Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Providence Setting Facility Modifier None Typical Low $12.30 Median $15.14 Typical High $19.95 | Facility | None | $12.30 | $15.14 | $19.95 |
Providence Setting Professional Modifier None Typical Low $10.47 Median $15.49 Typical High $79.43 | Professional | None | $10.47 | $15.49 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | None | $18.20 | $19.95 | $19.95 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.71 Typical High $17.38 | Professional | None | $8.13 | $8.71 | $17.38 |
4 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 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $1.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.29 |
Where Oregon sits
The same service costs 3.0 times more in Hawaii than in Rhode Island. 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· 18th of 51
$15.14
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.