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 $3.47 Median $4.90 Typical High $4.90 | Professional | None | $3.47 | $4.90 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.13 Median $13.18 Typical High $16.22 | Professional | None | $5.13 | $13.18 | $16.22 |
Moda Health Setting Facility Modifier None Typical Low $4.79 Median $5.89 Typical High $6.76 | Facility | None | $4.79 | $5.89 | $6.76 |
Moda Health Setting Professional Modifier None Typical Low $4.90 Median $6.17 Typical High $6.76 | Professional | None | $4.90 | $6.17 | $6.76 |
Pacific Source Setting Facility Modifier None Typical Low $6.03 Median $6.46 Typical High $6.61 | Facility | None | $6.03 | $6.46 | $6.61 |
Pacific Source Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Providence Setting Facility Modifier None Typical Low $3.98 Median $5.75 Typical High $7.41 | Facility | None | $3.98 | $5.75 | $7.41 |
Providence Setting Professional Modifier None Typical Low $3.39 Median $5.75 Typical High $79.43 | Professional | None | $3.39 | $5.75 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $6.92 Median $7.41 Typical High $7.41 | Professional | None | $6.92 | $7.41 | $7.41 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.82 Typical High $5.50 | Professional | None | $2.57 | $2.82 | $5.50 |
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 $2.34 Median $2.45 Typical High $2.45 | Professional | 52 · Reduced service | $2.34 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $0.98 Typical High $0.98 | Professional | 53 · Discontinued | $0.93 | $0.98 | $0.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.72 Typical High $0.72 | Professional | 55 · Aftercare only | $0.71 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.49 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.47 | $0.49 | $0.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.34 Median $2.45 Typical High $2.45 | Professional | 52 · Reduced service | $2.34 | $2.45 | $2.45 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $0.98 Typical High $0.98 | Professional | 53 · Discontinued | $0.93 | $0.98 | $0.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.72 Typical High $0.72 | Professional | 55 · Aftercare only | $0.71 | $0.72 | $0.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.49 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.47 | $0.49 | $0.49 |
Where Oregon sits
The same service costs 2.1 times more in Kansas than in Alabama. 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· 13th of 51
$5.75
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.