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 $1.45 Median $3.47 Typical High $3.47 | Professional | None | $1.45 | $3.47 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Facility | None | $2.88 | $2.88 | $2.88 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.88 | Professional | None | $2.45 | $2.45 | $2.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.63 Median $9.33 Typical High $11.22 | Professional | None | $3.63 | $9.33 | $11.22 |
Moda Health Setting Facility Modifier None Typical Low $3.39 Median $4.17 Typical High $4.90 | Facility | None | $3.39 | $4.17 | $4.90 |
Moda Health Setting Professional Modifier None Typical Low $3.47 Median $4.37 Typical High $4.90 | Professional | None | $3.47 | $4.37 | $4.90 |
Pacific Source Setting Facility Modifier None Typical Low $4.27 Median $4.68 Typical High $4.79 | Facility | None | $4.27 | $4.68 | $4.79 |
Pacific Source Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Providence Setting Facility Modifier None Typical Low $2.88 Median $4.07 Typical High $5.37 | Facility | None | $2.88 | $4.07 | $5.37 |
Providence Setting Professional Modifier None Typical Low $2.45 Median $4.17 Typical High $79.43 | Professional | None | $2.45 | $4.17 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.90 Median $5.37 Typical High $5.37 | Professional | None | $4.90 | $5.37 | $5.37 |
United Setting Professional Modifier None Typical Low $1.86 Median $2.04 Typical High $3.98 | Professional | None | $1.86 | $2.04 | $3.98 |
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 $0.51 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.51 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.34 | $0.35 | $0.35 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.51 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.51 | $0.52 | $0.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.34 | $0.35 | $0.35 |
Where Oregon sits
The same service costs 2.8 times more in Kansas than in Delaware. 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
$4.17
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.