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 $33.11 Median $43.65 Typical High $43.65 | Professional | None | $33.11 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $125.89 Typical High $151.36 | Professional | None | $45.71 | $125.89 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $38.02 Median $45.71 Typical High $61.66 | Facility | None | $38.02 | $45.71 | $61.66 |
Moda Health Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $60.26 | Professional | None | $43.65 | $54.95 | $60.26 |
Pacific Source Setting Facility Modifier None Typical Low $46.77 Median $57.54 Typical High $58.88 | Facility | None | $46.77 | $57.54 | $58.88 |
Pacific Source Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Providence Setting Facility Modifier None Typical Low $38.02 Median $51.29 Typical High $66.07 | Facility | None | $38.02 | $51.29 | $66.07 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $52.48 Typical High $79.43 | Professional | None | $32.36 | $52.48 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | None | $61.66 | $66.07 | $66.07 |
United Setting Professional Modifier None Typical Low $25.12 Median $26.92 Typical High $52.48 | Professional | None | $25.12 | $26.92 | $52.48 |
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 $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
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· 15th of 51
$51.29
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.