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 $27.54 Median $28.84 Typical High $28.84 | Professional | None | $27.54 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $22.39 | Professional | None | $16.22 | $22.39 | $22.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.20 Median $77.62 Typical High $93.33 | Professional | None | $30.20 | $77.62 | $93.33 |
Moda Health Setting Facility Modifier None Typical Low $28.84 Median $30.90 Typical High $39.81 | Facility | None | $28.84 | $30.90 | $39.81 |
Moda Health Setting Professional Modifier None Typical Low $28.84 Median $36.31 Typical High $39.81 | Professional | None | $28.84 | $36.31 | $39.81 |
Pacific Source Setting Facility Modifier None Typical Low $35.48 Median $38.90 Typical High $39.81 | Facility | None | $35.48 | $38.90 | $39.81 |
Pacific Source Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $39.81 | Professional | None | $35.48 | $39.81 | $39.81 |
Providence Setting Facility Modifier None Typical Low $25.12 Median $33.88 Typical High $44.67 | Facility | None | $25.12 | $33.88 | $44.67 |
Providence Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $70.79 | Professional | None | $16.22 | $22.39 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $44.67 | Professional | None | $40.74 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $15.49 Median $16.60 Typical High $32.36 | Professional | None | $15.49 | $16.60 | $32.36 |
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 $4.17 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.17 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.75 | $2.88 | $2.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.17 | $4.37 | $4.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.75 | $2.88 | $2.88 |
Where Oregon sits
The same service costs 3.0 times more in Hawaii than in Kansas. 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
$29.51
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.