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 $4.79 Median $6.17 Typical High $6.17 | Professional | None | $4.79 | $6.17 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Facility | None | $5.01 | $5.01 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.01 | Professional | None | $4.27 | $4.27 | $5.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.46 Median $16.22 Typical High $19.95 | Professional | None | $6.46 | $16.22 | $19.95 |
Moda Health Setting Facility Modifier None Typical Low $6.03 Median $6.76 Typical High $8.51 | Facility | None | $6.03 | $6.76 | $8.51 |
Moda Health Setting Professional Modifier None Typical Low $6.17 Median $7.76 Typical High $8.51 | Professional | None | $6.17 | $7.76 | $8.51 |
Pacific Source Setting Facility Modifier None Typical Low $7.59 Median $8.13 Typical High $8.32 | Facility | None | $7.59 | $8.13 | $8.32 |
Providence Setting Facility Modifier None Typical Low $5.01 Median $7.24 Typical High $9.33 | Facility | None | $5.01 | $7.24 | $9.33 |
Providence Setting Professional Modifier None Typical Low $4.27 Median $7.41 Typical High $79.43 | Professional | None | $4.27 | $7.41 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | None | $8.71 | $9.33 | $9.33 |
United Setting Professional Modifier None Typical Low $3.31 Median $3.55 Typical High $6.92 | Professional | None | $3.31 | $3.55 | $6.92 |
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 $0.89 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.89 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.59 | $0.62 | $0.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.89 | $0.91 | $0.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.59 | $0.62 | $0.62 |
Where Oregon sits
The same service costs 2.1 times more in Hawaii 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
$7.41
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.