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 $14.79 Median $15.49 Typical High $15.49 | Professional | None | $14.79 | $15.49 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $11.75 | Professional | None | $8.71 | $11.75 | $11.75 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.98 Median $41.69 Typical High $50.12 | Professional | None | $16.98 | $41.69 | $50.12 |
Moda Health Setting Facility Modifier None Typical Low $15.49 Median $16.60 Typical High $21.38 | Facility | None | $15.49 | $16.60 | $21.38 |
Moda Health Setting Professional Modifier None Typical Low $15.49 Median $19.50 Typical High $21.38 | Professional | None | $15.49 | $19.50 | $21.38 |
Pacific Source Setting Facility Modifier None Typical Low $18.62 Median $20.42 Typical High $20.89 | Facility | None | $18.62 | $20.42 | $20.89 |
Pacific Source Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | None | $20.89 | $20.89 | $23.99 |
Providence Setting Facility Modifier None Typical Low $13.49 Median $17.78 Typical High $23.44 | Facility | None | $13.49 | $17.78 | $23.44 |
Providence Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $70.79 | Professional | None | $8.71 | $11.75 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $23.44 | Professional | None | $21.88 | $23.44 | $23.44 |
United Setting Professional Modifier None Typical Low $8.32 Median $8.91 Typical High $17.38 | Professional | None | $8.32 | $8.91 | $17.38 |
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 $2.24 Median $2.29 Typical High $2.29 | Professional | 55 · Aftercare only | $2.24 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.48 | $1.55 | $1.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.29 Typical High $2.29 | Professional | 55 · Aftercare only | $2.24 | $2.29 | $2.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.48 | $1.55 | $1.55 |
Where Oregon sits
The same service costs 2.3 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· 17th of 51
$15.85
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.