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 $1.78 Median $1.86 Typical High $1.86 | Professional | None | $1.78 | $1.86 | $1.86 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Cigna Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.70 | Professional | None | $1.45 | $1.45 | $1.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.95 Median $4.68 Typical High $5.62 | Professional | None | $1.95 | $4.68 | $5.62 |
Moda Health Setting Facility Modifier None Typical Low $1.82 Median $2.09 Typical High $2.57 | Facility | None | $1.82 | $2.09 | $2.57 |
Moda Health Setting Professional Modifier None Typical Low $1.86 Median $2.34 Typical High $2.57 | Professional | None | $1.86 | $2.34 | $2.57 |
Pacific Source Setting Facility Modifier None Typical Low $2.29 Median $2.45 Typical High $2.51 | Facility | None | $2.29 | $2.45 | $2.51 |
Pacific Source Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Providence Setting Facility Modifier None Typical Low $1.62 Median $2.19 Typical High $2.82 | Facility | None | $1.62 | $2.19 | $2.82 |
Providence Setting Professional Modifier None Typical Low $1.45 Median $2.19 Typical High $79.43 | Professional | None | $1.45 | $2.19 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.63 Median $2.82 Typical High $2.82 | Professional | None | $2.63 | $2.82 | $2.82 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.07 Typical High $2.09 | Professional | None | $1.00 | $1.07 | $2.09 |
8 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 52 · Reduced service Typical Low $0.89 Median $0.93 Typical High $0.93 | Professional | 52 · Reduced service | $0.89 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.37 Typical High $0.37 | Professional | 53 · Discontinued | $0.36 | $0.37 | $0.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.27 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.18 | $0.19 | $0.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.89 Median $0.93 Typical High $0.93 | Professional | 52 · Reduced service | $0.89 | $0.93 | $0.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.37 Typical High $0.37 | Professional | 53 · Discontinued | $0.36 | $0.37 | $0.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.27 | $0.28 | $0.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.18 | $0.19 | $0.19 |
Where Oregon sits
The same service costs 2.3 times more in Kansas than in Connecticut. 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
$2.19
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.