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 $0.98 Median $1.62 Typical High $1.62 | Professional | None | $0.98 | $1.62 | $1.62 |
Cigna Setting Facility Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Facility | None | $1.35 | $1.35 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.35 | Professional | None | $1.12 | $1.12 | $1.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.70 Median $4.68 Typical High $5.62 | Professional | None | $1.70 | $4.68 | $5.62 |
Moda Health Setting Facility Modifier None Typical Low $1.62 Median $1.74 Typical High $2.29 | Facility | None | $1.62 | $1.74 | $2.29 |
Moda Health Setting Professional Modifier None Typical Low $1.62 Median $2.09 Typical High $2.29 | Professional | None | $1.62 | $2.09 | $2.29 |
Pacific Source Setting Facility Modifier None Typical Low $1.95 Median $2.19 Typical High $2.24 | Facility | None | $1.95 | $2.19 | $2.24 |
Pacific Source Setting Professional Modifier None Typical Low $2.00 Median $2.24 Typical High $2.29 | Professional | None | $2.00 | $2.24 | $2.29 |
Providence Setting Facility Modifier None Typical Low $1.23 Median $1.91 Typical High $2.51 | Facility | None | $1.23 | $1.91 | $2.51 |
Providence Setting Professional Modifier None Typical Low $1.12 Median $1.95 Typical High $79.43 | Professional | None | $1.12 | $1.95 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.29 Median $2.51 Typical High $2.51 | Professional | None | $2.29 | $2.51 | $2.51 |
United Setting Professional Modifier None Typical Low $0.87 Median $0.95 Typical High $1.86 | Professional | None | $0.87 | $0.95 | $1.86 |
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 $0.24 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.24 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.16 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.24 | $0.25 | $0.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.16 |
Where Oregon sits
The same service costs 5.8 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· 13th of 51
$1.95
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.