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 $1.02 Median $1.32 Typical High $1.32 | Professional | None | $1.02 | $1.32 | $1.32 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.10 | Professional | None | $0.93 | $0.93 | $1.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.38 Median $3.89 Typical High $4.68 | Professional | None | $1.38 | $3.89 | $4.68 |
Moda Health Setting Facility Modifier None Typical Low $1.32 Median $1.41 Typical High $1.82 | Facility | None | $1.32 | $1.41 | $1.82 |
Moda Health Setting Professional Modifier None Typical Low $1.32 Median $1.66 Typical High $1.82 | Professional | None | $1.32 | $1.66 | $1.82 |
Pacific Source Setting Facility Modifier None Typical Low $1.62 Median $1.78 Typical High $1.82 | Facility | None | $1.62 | $1.78 | $1.82 |
Pacific Source Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.91 | Professional | None | $1.82 | $1.82 | $1.91 |
Providence Setting Facility Modifier None Typical Low $1.10 Median $1.55 Typical High $2.04 | Facility | None | $1.10 | $1.55 | $2.04 |
Providence Setting Professional Modifier None Typical Low $0.93 Median $1.55 Typical High $79.43 | Professional | None | $0.93 | $1.55 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.86 Median $2.04 Typical High $2.04 | Professional | None | $1.86 | $2.04 | $2.04 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.78 Typical High $1.51 | Professional | None | $0.71 | $0.78 | $1.51 |
8 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 52 · Reduced service Typical Low $0.65 Median $0.66 Typical High $0.66 | Professional | 52 · Reduced service | $0.65 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 53 · Discontinued | $0.26 | $0.26 | $0.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.19 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.65 Median $0.66 Typical High $0.66 | Professional | 52 · Reduced service | $0.65 | $0.66 | $0.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 53 · Discontinued | $0.26 | $0.26 | $0.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.19 | $0.20 | $0.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Where Oregon sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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
$1.55
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.