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 $5.01 Median $7.59 Typical High $7.59 | Professional | None | $5.01 | $7.59 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.17 | Professional | None | $5.25 | $5.25 | $6.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.94 Median $20.42 Typical High $24.55 | Professional | None | $7.94 | $20.42 | $24.55 |
Moda Health Setting Facility Modifier None Typical Low $5.89 Median $7.76 Typical High $10.47 | Facility | None | $5.89 | $7.76 | $10.47 |
Moda Health Setting Professional Modifier None Typical Low $7.59 Median $9.55 Typical High $10.47 | Professional | None | $7.59 | $9.55 | $10.47 |
Pacific Source Setting Facility Modifier None Typical Low $9.12 Median $10.00 Typical High $10.23 | Facility | None | $9.12 | $10.00 | $10.23 |
Providence Setting Facility Modifier None Typical Low $6.17 Median $8.71 Typical High $11.48 | Facility | None | $6.17 | $8.71 | $11.48 |
Providence Setting Professional Modifier None Typical Low $5.25 Median $9.12 Typical High $79.43 | Professional | None | $5.25 | $9.12 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $10.72 Median $11.48 Typical High $11.48 | Professional | None | $10.72 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $4.07 Median $4.37 Typical High $8.51 | Professional | None | $4.07 | $4.37 | $8.51 |
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 $0.98 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $0.98 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.66 Median $0.76 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.66 | $0.76 | $0.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.98 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $0.98 | $1.12 | $1.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.66 Median $0.76 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.66 | $0.76 | $0.76 |
Where Oregon sits
The same service costs 2.1 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· 11th of 51
$9.12
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.