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 $5.13 Median $6.61 Typical High $6.61 | Professional | None | $5.13 | $6.61 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | None | $4.68 | $4.68 | $5.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.92 Median $17.78 Typical High $21.88 | Professional | None | $6.92 | $17.78 | $21.88 |
Moda Health Setting Facility Modifier None Typical Low $6.61 Median $7.24 Typical High $9.33 | Facility | None | $6.61 | $7.24 | $9.33 |
Moda Health Setting Professional Modifier None Typical Low $6.61 Median $8.51 Typical High $9.33 | Professional | None | $6.61 | $8.51 | $9.33 |
Pacific Source Setting Facility Modifier None Typical Low $8.13 Median $8.91 Typical High $9.12 | Facility | None | $8.13 | $8.91 | $9.12 |
Pacific Source Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
Providence Setting Facility Modifier None Typical Low $5.50 Median $7.76 Typical High $10.23 | Facility | None | $5.50 | $7.76 | $10.23 |
Providence Setting Professional Modifier None Typical Low $4.68 Median $7.94 Typical High $79.43 | Professional | None | $4.68 | $7.94 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $9.33 Median $10.23 Typical High $10.23 | Professional | None | $9.33 | $10.23 | $10.23 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.89 Typical High $7.59 | Professional | None | $3.55 | $3.89 | $7.59 |
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 $3.24 Median $3.31 Typical High $3.31 | Professional | 52 · Reduced service | $3.24 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.35 Typical High $1.35 | Professional | 53 · Discontinued | $1.29 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $1.00 Typical High $1.00 | Professional | 55 · Aftercare only | $0.95 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.68 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.65 | $0.68 | $0.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | 52 · Reduced service | $3.24 | $3.31 | $3.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.35 Typical High $1.35 | Professional | 53 · Discontinued | $1.29 | $1.35 | $1.35 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $1.00 Typical High $1.00 | Professional | 55 · Aftercare only | $0.95 | $1.00 | $1.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.68 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.65 | $0.68 | $0.68 |
Where Oregon sits
The same service costs 2.3 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· 11th of 51
$7.94
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.