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 $6.46 Median $8.32 Typical High $8.32 | Professional | None | $6.46 | $8.32 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Facility | None | $6.92 | $6.92 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.92 | Professional | None | $5.89 | $5.89 | $6.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.71 Median $22.39 Typical High $27.54 | Professional | None | $8.71 | $22.39 | $27.54 |
Moda Health Setting Facility Modifier None Typical Low $8.32 Median $9.12 Typical High $11.75 | Facility | None | $8.32 | $9.12 | $11.75 |
Moda Health Setting Professional Modifier None Typical Low $8.32 Median $10.47 Typical High $11.75 | Professional | None | $8.32 | $10.47 | $11.75 |
Pacific Source Setting Facility Modifier None Typical Low $10.23 Median $11.22 Typical High $11.48 | Facility | None | $10.23 | $11.22 | $11.48 |
Pacific Source Setting Professional Modifier None Typical Low $10.23 Median $11.48 Typical High $11.48 | Professional | None | $10.23 | $11.48 | $11.48 |
Providence Setting Facility Modifier None Typical Low $6.92 Median $9.77 Typical High $12.88 | Facility | None | $6.92 | $9.77 | $12.88 |
Providence Setting Professional Modifier None Typical Low $5.89 Median $10.00 Typical High $79.43 | Professional | None | $5.89 | $10.00 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $11.75 Median $12.88 Typical High $12.88 | Professional | None | $11.75 | $12.88 | $12.88 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.79 Typical High $9.55 | Professional | None | $4.47 | $4.79 | $9.55 |
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 $1.20 Median $1.26 Typical High $1.26 | Professional | 55 · Aftercare only | $1.20 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.83 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.81 | $0.83 | $0.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.26 Typical High $1.26 | Professional | 55 · Aftercare only | $1.20 | $1.26 | $1.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.83 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.81 | $0.83 | $0.83 |
Where Oregon sits
The same service costs 2.1 times more in Idaho than in Colorado. 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· 11th of 51
$10.00
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.