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 $3.55 Median $9.12 Typical High $9.12 | Professional | None | $3.55 | $9.12 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | None | $5.01 | $5.13 | $5.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.23 Median $25.12 Typical High $30.20 | Professional | None | $10.23 | $25.12 | $30.20 |
Moda Health Setting Facility Modifier None Typical Low $8.91 Median $10.96 Typical High $12.59 | Facility | None | $8.91 | $10.96 | $12.59 |
Moda Health Setting Professional Modifier None Typical Low $9.12 Median $11.22 Typical High $12.59 | Professional | None | $9.12 | $11.22 | $12.59 |
Pacific Source Setting Facility Modifier None Typical Low $10.00 Median $11.22 Typical High $12.59 | Facility | None | $10.00 | $11.22 | $12.59 |
Pacific Source Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Providence Setting Facility Modifier None Typical Low $5.89 Median $10.72 Typical High $14.13 | Facility | None | $5.89 | $10.72 | $14.13 |
Providence Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $70.79 | Professional | None | $5.01 | $5.13 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $14.13 | Professional | None | $12.88 | $14.13 | $14.13 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.25 Typical High $10.23 | Professional | None | $4.90 | $5.25 | $10.23 |
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 $1.32 Median $1.38 Typical High $1.38 | Professional | 55 · Aftercare only | $1.32 | $1.38 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.91 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.87 | $0.91 | $0.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.32 Median $1.38 Typical High $1.38 | Professional | 55 · Aftercare only | $1.32 | $1.38 | $1.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.91 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.87 | $0.91 | $0.91 |
Where Oregon sits
The same service costs 2.7 times more in Hawaii than in Vermont. 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
$9.33
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.