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 $25.12 Median $32.36 Typical High $32.36 | Professional | None | $25.12 | $32.36 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | None | $22.91 | $22.91 | $26.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.88 Median $87.10 Typical High $104.71 | Professional | None | $33.88 | $87.10 | $104.71 |
Moda Health Setting Facility Modifier None Typical Low $31.62 Median $38.90 Typical High $45.71 | Facility | None | $31.62 | $38.90 | $45.71 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $45.71 | Professional | None | $32.36 | $40.74 | $45.71 |
Pacific Source Setting Facility Modifier None Typical Low $35.48 Median $39.81 Typical High $44.67 | Facility | None | $35.48 | $39.81 | $44.67 |
Providence Setting Facility Modifier None Typical Low $26.92 Median $38.02 Typical High $50.12 | Facility | None | $26.92 | $38.02 | $50.12 |
Providence Setting Professional Modifier None Typical Low $22.91 Median $38.90 Typical High $79.43 | Professional | None | $22.91 | $38.90 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $50.12 | Professional | None | $45.71 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $37.15 | Professional | None | $17.38 | $18.62 | $37.15 |
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 $4.17 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.17 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.82 | $3.24 | $3.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.68 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.16 | $3.24 | $3.24 |
Where Oregon sits
The same service costs 2.5 times more in Idaho than in Kentucky. 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· 12th of 51
$37.15
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.