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 $19.95 Median $21.88 Typical High $21.88 | Professional | None | $19.95 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | None | $18.20 | $18.20 | $21.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.91 Median $70.79 Typical High $85.11 | Professional | None | $22.91 | $70.79 | $85.11 |
Moda Health Setting Facility Modifier None Typical Low $21.38 Median $22.91 Typical High $31.62 | Facility | None | $21.38 | $22.91 | $31.62 |
Moda Health Setting Professional Modifier None Typical Low $21.88 Median $27.54 Typical High $30.90 | Professional | None | $21.88 | $27.54 | $30.90 |
Pacific Source Setting Facility Modifier None Typical Low $23.99 Median $29.51 Typical High $33.11 | Facility | None | $23.99 | $29.51 | $33.11 |
Providence Setting Facility Modifier None Typical Low $21.38 Median $25.70 Typical High $33.88 | Facility | None | $21.38 | $25.70 | $33.88 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $26.30 Typical High $79.43 | Professional | None | $18.20 | $26.30 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.90 Median $33.88 Typical High $33.88 | Professional | None | $30.90 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $29.51 | Professional | None | $13.80 | $15.14 | $29.51 |
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 $3.31 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.19 |
Where Oregon sits
The same service costs 2.6 times more in Hawaii 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· 18th of 51
$25.70
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.