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 $1.58 Median $2.29 Typical High $2.29 | Professional | None | $1.58 | $2.29 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Facility | None | $1.86 | $1.86 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.86 | Professional | None | $1.58 | $1.58 | $1.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.34 Median $6.17 Typical High $7.59 | Professional | None | $2.34 | $6.17 | $7.59 |
Moda Health Setting Facility Modifier None Typical Low $2.19 Median $2.69 Typical High $3.16 | Facility | None | $2.19 | $2.69 | $3.16 |
Moda Health Setting Professional Modifier None Typical Low $2.29 Median $2.88 Typical High $3.16 | Professional | None | $2.29 | $2.88 | $3.16 |
Pacific Source Setting Facility Modifier None Typical Low $2.45 Median $3.02 Typical High $3.09 | Facility | None | $2.45 | $3.02 | $3.09 |
Pacific Source Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
Providence Setting Facility Modifier None Typical Low $1.86 Median $2.63 Typical High $3.47 | Facility | None | $1.86 | $2.63 | $3.47 |
Providence Setting Professional Modifier None Typical Low $1.58 Median $2.69 Typical High $79.43 | Professional | None | $1.58 | $2.69 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $3.47 | Professional | None | $3.24 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $1.20 Median $1.32 Typical High $2.57 | Professional | None | $1.20 | $1.32 | $2.57 |
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 $0.33 Median $0.34 Typical High $0.34 | Professional | 55 · Aftercare only | $0.33 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.22 | $0.23 | $0.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.34 Typical High $0.34 | Professional | 55 · Aftercare only | $0.33 | $0.34 | $0.34 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.22 | $0.23 | $0.23 |
Where Oregon sits
The same service costs 3.0 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· 16th of 51
$2.51
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.