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 $3.63 Median $4.79 Typical High $4.79 | Professional | None | $3.63 | $4.79 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.89 | Professional | None | $3.31 | $3.31 | $3.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $12.59 Typical High $15.14 | Professional | None | $4.90 | $12.59 | $15.14 |
Moda Health Setting Facility Modifier None Typical Low $4.57 Median $5.62 Typical High $6.61 | Facility | None | $4.57 | $5.62 | $6.61 |
Moda Health Setting Professional Modifier None Typical Low $4.79 Median $6.03 Typical High $6.61 | Professional | None | $4.79 | $6.03 | $6.61 |
Pacific Source Setting Facility Modifier None Typical Low $5.75 Median $6.31 Typical High $6.46 | Facility | None | $5.75 | $6.31 | $6.46 |
Pacific Source Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Providence Setting Facility Modifier None Typical Low $3.89 Median $5.50 Typical High $7.24 | Facility | None | $3.89 | $5.50 | $7.24 |
Providence Setting Professional Modifier None Typical Low $3.31 Median $5.62 Typical High $79.43 | Professional | None | $3.31 | $5.62 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $6.61 Median $7.24 Typical High $7.24 | Professional | None | $6.61 | $7.24 | $7.24 |
United Setting Professional Modifier None Typical Low $2.51 Median $2.75 Typical High $5.37 | Professional | None | $2.51 | $2.75 | $5.37 |
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 $0.69 Median $0.71 Typical High $0.71 | Professional | 55 · Aftercare only | $0.69 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.47 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.46 | $0.47 | $0.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.69 Median $0.71 Typical High $0.71 | Professional | 55 · Aftercare only | $0.69 | $0.71 | $0.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.47 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.46 | $0.47 | $0.47 |
Where Oregon sits
The same service costs 2.6 times more in Kansas 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· 13th of 51
$5.62
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.