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 $9.55 Median $9.77 Typical High $9.77 | Professional | None | $9.55 | $9.77 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.13 | Professional | None | $6.92 | $6.92 | $8.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.96 Median $26.30 Typical High $32.36 | Professional | None | $10.96 | $26.30 | $32.36 |
Moda Health Setting Facility Modifier None Typical Low $9.77 Median $10.72 Typical High $13.80 | Facility | None | $9.77 | $10.72 | $13.80 |
Moda Health Setting Professional Modifier None Typical Low $9.77 Median $12.59 Typical High $13.80 | Professional | None | $9.77 | $12.59 | $13.80 |
Pacific Source Setting Facility Modifier None Typical Low $12.02 Median $13.18 Typical High $13.49 | Facility | None | $12.02 | $13.18 | $13.49 |
Pacific Source Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Providence Setting Facility Modifier None Typical Low $8.13 Median $11.48 Typical High $15.14 | Facility | None | $8.13 | $11.48 | $15.14 |
Providence Setting Professional Modifier None Typical Low $6.92 Median $11.75 Typical High $79.43 | Professional | None | $6.92 | $11.75 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $15.14 | Professional | None | $13.80 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $11.22 | Professional | None | $5.25 | $5.75 | $11.22 |
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 $1.41 Median $1.48 Typical High $1.48 | Professional | 55 · Aftercare only | $1.41 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.95 | $1.00 | $1.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.48 Typical High $1.48 | Professional | 55 · Aftercare only | $1.41 | $1.48 | $1.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.95 | $1.00 | $1.00 |
Where Oregon sits
The same service costs 5.4 times more in Kansas 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· 13th of 51
$11.75
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.