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 $2.00 Median $2.82 Typical High $2.82 | Professional | None | $2.00 | $2.82 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Facility | None | $2.34 | $2.34 | $2.34 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.34 | Professional | None | $2.00 | $2.00 | $2.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.02 Median $7.76 Typical High $9.33 | Professional | None | $3.02 | $7.76 | $9.33 |
Moda Health Setting Facility Modifier None Typical Low $2.75 Median $3.39 Typical High $3.98 | Facility | None | $2.75 | $3.39 | $3.98 |
Moda Health Setting Professional Modifier None Typical Low $2.82 Median $3.63 Typical High $3.98 | Professional | None | $2.82 | $3.63 | $3.98 |
Pacific Source Setting Facility Modifier None Typical Low $3.47 Median $3.80 Typical High $3.89 | Facility | None | $3.47 | $3.80 | $3.89 |
Pacific Source Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Providence Setting Facility Modifier None Typical Low $2.34 Median $3.31 Typical High $4.37 | Facility | None | $2.34 | $3.31 | $4.37 |
Providence Setting Professional Modifier None Typical Low $2.00 Median $3.39 Typical High $79.43 | Professional | None | $2.00 | $3.39 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.07 Median $4.37 Typical High $4.37 | Professional | None | $4.07 | $4.37 | $4.37 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.66 Typical High $3.24 | Professional | None | $1.51 | $1.66 | $3.24 |
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 $1.38 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.38 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.55 Median $0.56 Typical High $0.56 | Professional | 53 · Discontinued | $0.55 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.41 Median $0.43 Typical High $0.43 | Professional | 55 · Aftercare only | $0.41 | $0.43 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.38 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.38 | $1.45 | $1.45 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.55 Median $0.58 Typical High $0.58 | Professional | 53 · Discontinued | $0.55 | $0.58 | $0.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.41 Median $0.43 Typical High $0.43 | Professional | 55 · Aftercare only | $0.41 | $0.43 | $0.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.29 Typical High $0.29 | Professional | 56 · Pre-op care only | $0.28 | $0.29 | $0.29 |
Where Oregon sits
The same service costs 2.2 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
$3.39
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.