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 $1.10 Median $1.45 Typical High $1.45 | Professional | None | $1.10 | $1.45 | $1.45 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.41 | Professional | None | $1.20 | $1.20 | $1.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.51 Median $4.68 Typical High $5.62 | Professional | None | $1.51 | $4.68 | $5.62 |
Moda Health Setting Facility Modifier None Typical Low $1.45 Median $1.51 Typical High $2.09 | Facility | None | $1.45 | $1.51 | $2.09 |
Moda Health Setting Professional Modifier None Typical Low $1.45 Median $1.86 Typical High $2.04 | Professional | None | $1.45 | $1.86 | $2.04 |
Pacific Source Setting Facility Modifier None Typical Low $1.82 Median $1.95 Typical High $2.34 | Facility | None | $1.82 | $1.95 | $2.34 |
Pacific Source Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Providence Setting Facility Modifier None Typical Low $1.41 Median $1.70 Typical High $2.24 | Facility | None | $1.41 | $1.70 | $2.24 |
Providence Setting Professional Modifier None Typical Low $1.20 Median $1.74 Typical High $79.43 | Professional | None | $1.20 | $1.74 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.04 Median $2.24 Typical High $2.24 | Professional | None | $2.04 | $2.24 | $2.24 |
United Setting Professional Modifier None Typical Low $0.91 Median $1.00 Typical High $1.95 | Professional | None | $0.91 | $1.00 | $1.95 |
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 $0.22 Median $0.22 Typical High $0.22 | Professional | 55 · Aftercare only | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 55 · Aftercare only | $0.22 | $0.22 | $0.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Where Oregon sits
The same service costs 5.4 times more in Kansas than in Kentucky. 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· 16th of 51
$1.82
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.