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 $13.49 Median $15.85 Typical High $15.85 | Professional | None | $13.49 | $15.85 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | None | $12.88 | $12.88 | $15.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $17.38 Median $50.12 Typical High $60.26 | Professional | None | $17.38 | $50.12 | $60.26 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $16.22 Typical High $21.88 | Facility | None | $15.14 | $16.22 | $21.88 |
Moda Health Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $21.88 | Professional | None | $15.85 | $19.95 | $21.88 |
Pacific Source Setting Facility Modifier None Typical Low $16.98 Median $20.89 Typical High $23.44 | Facility | None | $16.98 | $20.89 | $23.44 |
Pacific Source Setting Professional Modifier None Typical Low $16.98 Median $21.38 Typical High $27.54 | Professional | None | $16.98 | $21.38 | $27.54 |
Providence Setting Facility Modifier None Typical Low $14.45 Median $18.20 Typical High $23.99 | Facility | None | $14.45 | $18.20 | $23.99 |
Providence Setting Professional Modifier None Typical Low $12.88 Median $18.62 Typical High $79.43 | Professional | None | $12.88 | $18.62 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $21.88 Median $23.99 Typical High $23.99 | Professional | None | $21.88 | $23.99 | $23.99 |
United Setting Professional Modifier None Typical Low $9.77 Median $10.72 Typical High $20.89 | Professional | None | $9.77 | $10.72 | $20.89 |
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 $2.34 Median $2.34 Typical High $2.34 | Professional | 55 · Aftercare only | $2.34 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $1.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | 55 · Aftercare only | $2.34 | $2.34 | $2.34 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $1.58 |
Where Oregon sits
The same service costs 3.5 times more in Hawaii than in Connecticut. 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· 17th of 51
$18.62
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.