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 $6.76 Median $8.71 Typical High $8.71 | Professional | None | $6.76 | $8.71 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | None | $6.03 | $6.03 | $7.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.12 Median $23.44 Typical High $28.18 | Professional | None | $9.12 | $23.44 | $28.18 |
Moda Health Setting Facility Modifier None Typical Low $8.51 Median $9.77 Typical High $12.02 | Facility | None | $8.51 | $9.77 | $12.02 |
Moda Health Setting Professional Modifier None Typical Low $8.71 Median $10.96 Typical High $12.02 | Professional | None | $8.71 | $10.96 | $12.02 |
Pacific Source Setting Facility Modifier None Typical Low $10.72 Median $11.75 Typical High $12.02 | Facility | None | $10.72 | $11.75 | $12.02 |
Pacific Source Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Providence Setting Facility Modifier None Typical Low $7.08 Median $10.23 Typical High $13.49 | Facility | None | $7.08 | $10.23 | $13.49 |
Providence Setting Professional Modifier None Typical Low $6.03 Median $10.47 Typical High $79.43 | Professional | None | $6.03 | $10.47 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.30 Median $13.49 Typical High $13.49 | Professional | None | $12.30 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $4.68 Median $5.01 Typical High $9.77 | Professional | None | $4.68 | $5.01 | $9.77 |
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 $4.17 Median $4.37 Typical High $4.37 | Professional | 52 · Reduced service | $4.17 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.70 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.32 Typical High $1.32 | Professional | 55 · Aftercare only | $1.26 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.87 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.83 | $0.87 | $0.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.17 Median $4.37 Typical High $4.37 | Professional | 52 · Reduced service | $4.17 | $4.37 | $4.37 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.70 | $1.74 | $1.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.32 Typical High $1.32 | Professional | 55 · Aftercare only | $1.26 | $1.32 | $1.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.87 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.83 | $0.87 | $0.87 |
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
$10.47
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.