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 Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $69.18 | Facility | None | $22.91 | $22.91 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $22.91 Typical High $22.91 | Professional | None | $20.89 | $22.91 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | None | $18.62 | $18.62 | $21.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.99 Median $72.44 Typical High $87.10 | Professional | None | $23.99 | $72.44 | $87.10 |
Moda Health Setting Facility Modifier None Typical Low $22.39 Median $23.44 Typical High $33.11 | Facility | None | $22.39 | $23.44 | $33.11 |
Moda Health Setting Professional Modifier None Typical Low $22.91 Median $28.84 Typical High $31.62 | Professional | None | $22.91 | $28.84 | $31.62 |
Pacific Source Setting Facility Modifier None Typical Low $25.12 Median $30.90 Typical High $34.67 | Facility | None | $25.12 | $30.90 | $34.67 |
Providence Setting Facility Modifier None Typical Low $21.38 Median $26.92 Typical High $35.48 | Facility | None | $21.38 | $26.92 | $35.48 |
Providence Setting Professional Modifier None Typical Low $18.62 Median $27.54 Typical High $79.43 | Professional | None | $18.62 | $27.54 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $35.48 | Professional | None | $32.36 | $35.48 | $35.48 |
United Setting Professional Modifier None Typical Low $14.45 Median $15.49 Typical High $30.90 | Professional | None | $14.45 | $15.49 | $30.90 |
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 $3.47 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $3.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.29 |
Where Oregon sits
The same service costs 2.9 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
$26.92
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.