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 $3.72 Median $8.91 Typical High $8.91 | Professional | None | $3.72 | $8.91 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Facility | None | $7.41 | $7.41 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | None | $6.31 | $6.31 | $7.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.33 Median $23.99 Typical High $29.51 | Professional | None | $9.33 | $23.99 | $29.51 |
Moda Health Setting Facility Modifier None Typical Low $8.91 Median $9.55 Typical High $12.59 | Facility | None | $8.91 | $9.55 | $12.59 |
Moda Health Setting Professional Modifier None Typical Low $8.91 Median $11.22 Typical High $12.59 | Professional | None | $8.91 | $11.22 | $12.59 |
Pacific Source Setting Facility Modifier None Typical Low $10.96 Median $12.02 Typical High $12.30 | Facility | None | $10.96 | $12.02 | $12.30 |
Pacific Source Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Providence Setting Facility Modifier None Typical Low $7.41 Median $10.47 Typical High $14.45 | Facility | None | $7.41 | $10.47 | $14.45 |
Providence Setting Professional Modifier None Typical Low $6.31 Median $10.47 Typical High $79.43 | Professional | None | $6.31 | $10.47 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.59 Median $13.80 Typical High $13.80 | Professional | None | $12.59 | $13.80 | $13.80 |
United Setting Professional Modifier None Typical Low $4.79 Median $5.25 Typical High $10.23 | Professional | None | $4.79 | $5.25 | $10.23 |
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 $1.29 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $1.29 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.89 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.87 | $0.89 | $0.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $1.29 | $1.35 | $1.35 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.89 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.87 | $0.89 | $0.89 |
Where Oregon sits
The same service costs 2.0 times more in Montana than in Florida. 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· 12th of 51
$10.47
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.