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 $3.72 Median $3.89 Typical High $3.89 | Professional | None | $3.72 | $3.89 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.27 Median $10.00 Typical High $12.30 | Professional | None | $4.27 | $10.00 | $12.30 |
Moda Health Setting Facility Modifier None Typical Low $3.80 Median $4.57 Typical High $5.37 | Facility | None | $3.80 | $4.57 | $5.37 |
Moda Health Setting Professional Modifier None Typical Low $3.89 Median $4.90 Typical High $5.37 | Professional | None | $3.89 | $4.90 | $5.37 |
Pacific Source Setting Facility Modifier None Typical Low $4.68 Median $5.13 Typical High $5.25 | Facility | None | $4.68 | $5.13 | $5.25 |
Pacific Source Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Providence Setting Facility Modifier None Typical Low $3.39 Median $4.47 Typical High $5.89 | Facility | None | $3.39 | $4.47 | $5.89 |
Providence Setting Professional Modifier None Typical Low $2.95 Median $4.57 Typical High $79.43 | Professional | None | $2.95 | $4.57 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.37 Median $5.89 Typical High $5.89 | Professional | None | $5.37 | $5.89 | $5.89 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.24 Typical High $4.37 | Professional | None | $2.04 | $2.24 | $4.37 |
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 $1.86 Median $1.95 Typical High $1.95 | Professional | 52 · Reduced service | $1.86 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.78 Typical High $0.78 | Professional | 53 · Discontinued | $0.74 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.58 Typical High $0.58 | Professional | 55 · Aftercare only | $0.56 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.39 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.37 | $0.39 | $0.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.86 Median $1.95 Typical High $1.95 | Professional | 52 · Reduced service | $1.86 | $1.95 | $1.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.78 Typical High $0.78 | Professional | 53 · Discontinued | $0.74 | $0.78 | $0.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.58 Typical High $0.58 | Professional | 55 · Aftercare only | $0.56 | $0.58 | $0.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.39 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.37 | $0.39 | $0.39 |
Where Oregon sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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· 14th of 51
$4.57
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.