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 $6.46 Median $9.33 Typical High $9.33 | Professional | None | $6.46 | $9.33 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | None | $6.46 | $6.46 | $7.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.55 Median $25.12 Typical High $30.20 | Professional | None | $9.55 | $25.12 | $30.20 |
Moda Health Setting Facility Modifier None Typical Low $9.12 Median $10.96 Typical High $12.88 | Facility | None | $9.12 | $10.96 | $12.88 |
Moda Health Setting Professional Modifier None Typical Low $9.33 Median $11.75 Typical High $12.88 | Professional | None | $9.33 | $11.75 | $12.88 |
Pacific Source Setting Facility Modifier None Typical Low $11.22 Median $12.30 Typical High $12.59 | Facility | None | $11.22 | $12.30 | $12.59 |
Pacific Source Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Providence Setting Facility Modifier None Typical Low $7.59 Median $10.72 Typical High $14.13 | Facility | None | $7.59 | $10.72 | $14.13 |
Providence Setting Professional Modifier None Typical Low $6.46 Median $10.96 Typical High $79.43 | Professional | None | $6.46 | $10.96 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $13.18 Median $14.13 Typical High $14.13 | Professional | None | $13.18 | $14.13 | $14.13 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.37 Typical High $10.47 | Professional | None | $4.90 | $5.37 | $10.47 |
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 $1.35 Median $1.38 Typical High $1.38 | Professional | 55 · Aftercare only | $1.35 | $1.38 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.89 | $0.93 | $0.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.38 Typical High $1.38 | Professional | 55 · Aftercare only | $1.35 | $1.38 | $1.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.89 | $0.93 | $0.93 |
Where Oregon sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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· 10th of 51
$10.96
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.