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 $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
Aetna Setting Professional Modifier None Typical Low $1.66 Median $2.14 Typical High $2.14 | Professional | None | $1.66 | $2.14 | $2.14 |
Cigna Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.04 | Professional | None | $1.74 | $1.74 | $2.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.19 Median $7.08 Typical High $8.51 | Professional | None | $2.19 | $7.08 | $8.51 |
Moda Health Setting Facility Modifier None Typical Low $2.04 Median $2.29 Typical High $3.02 | Facility | None | $2.04 | $2.29 | $3.02 |
Moda Health Setting Professional Modifier None Typical Low $2.14 Median $2.69 Typical High $2.95 | Professional | None | $2.14 | $2.69 | $2.95 |
Pacific Source Setting Facility Modifier None Typical Low $2.57 Median $2.82 Typical High $2.88 | Facility | None | $2.57 | $2.82 | $2.88 |
Pacific Source Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Providence Setting Facility Modifier None Typical Low $2.04 Median $2.45 Typical High $3.24 | Facility | None | $2.04 | $2.45 | $3.24 |
Providence Setting Professional Modifier None Typical Low $1.74 Median $2.51 Typical High $79.43 | Professional | None | $1.74 | $2.51 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.95 Median $3.24 Typical High $3.24 | Professional | None | $2.95 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.45 Typical High $2.82 | Professional | None | $1.32 | $1.45 | $2.82 |
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 $0.32 Median $0.32 Typical High $0.32 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $0.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.21 |
Where Oregon sits
The same service costs 3.8 times more in Kansas than in Alabama. 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
$2.57
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.