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 $34.67 Median $42.66 Typical High $42.66 | Professional | None | $34.67 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | None | $34.67 | $34.67 | $40.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $134.90 Typical High $162.18 | Professional | None | $44.67 | $134.90 | $162.18 |
Moda Health Setting Facility Modifier None Typical Low $37.15 Median $43.65 Typical High $60.26 | Facility | None | $37.15 | $43.65 | $60.26 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $58.88 | Professional | None | $42.66 | $53.70 | $58.88 |
Pacific Source Setting Facility Modifier None Typical Low $56.23 Median $57.54 Typical High $66.07 | Facility | None | $56.23 | $57.54 | $66.07 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $50.12 Typical High $64.57 | Facility | None | $39.81 | $50.12 | $64.57 |
Providence Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $79.43 | Professional | None | $34.67 | $51.29 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | None | $60.26 | $64.57 | $64.57 |
United Setting Professional Modifier None Typical Low $26.92 Median $28.84 Typical High $56.23 | Professional | None | $26.92 | $28.84 | $56.23 |
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 $6.31 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Where Oregon sits
The same service costs 3.0 times more in Hawaii than in Rhode Island. 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· 15th of 51
$51.29
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.