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 $16.22 Median $16.22 Typical High $50.12 | Facility | None | $16.22 | $16.22 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $16.22 Typical High $16.22 | Professional | None | $10.47 | $16.22 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | None | $11.48 | $11.48 | $13.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.98 Median $44.67 Typical High $53.70 | Professional | None | $16.98 | $44.67 | $53.70 |
Moda Health Setting Facility Modifier None Typical Low $15.85 Median $16.98 Typical High $23.44 | Facility | None | $15.85 | $16.98 | $23.44 |
Moda Health Setting Professional Modifier None Typical Low $16.22 Median $20.42 Typical High $22.91 | Professional | None | $16.22 | $20.42 | $22.91 |
Pacific Source Setting Facility Modifier None Typical Low $17.78 Median $19.50 Typical High $22.39 | Facility | None | $17.78 | $19.50 | $22.39 |
Pacific Source Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $22.39 | Professional | None | $19.05 | $19.05 | $22.39 |
Providence Setting Facility Modifier None Typical Low $12.30 Median $19.05 Typical High $25.12 | Facility | None | $12.30 | $19.05 | $25.12 |
Providence Setting Professional Modifier None Typical Low $11.48 Median $19.50 Typical High $79.43 | Professional | None | $11.48 | $19.50 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | None | $22.91 | $25.12 | $25.12 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.55 Typical High $18.62 | Professional | None | $8.71 | $9.55 | $18.62 |
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 $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.34 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.58 | $1.62 | $1.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.34 | $2.45 | $2.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.58 | $1.62 | $1.62 |
Where Oregon sits
The same service costs 2.8 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· 13th 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.