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 $2.51 Median $2.75 Typical High $2.75 | Professional | None | $2.51 | $2.75 | $2.75 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Facility | None | $2.69 | $2.69 | $2.69 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | None | $2.29 | $2.29 | $2.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.09 Median $8.51 Typical High $10.47 | Professional | None | $3.09 | $8.51 | $10.47 |
Moda Health Setting Facility Modifier None Typical Low $2.75 Median $3.02 Typical High $3.89 | Facility | None | $2.75 | $3.02 | $3.89 |
Moda Health Setting Professional Modifier None Typical Low $2.75 Median $3.55 Typical High $3.89 | Professional | None | $2.75 | $3.55 | $3.89 |
Pacific Source Setting Facility Modifier None Typical Low $3.02 Median $3.72 Typical High $4.47 | Facility | None | $3.02 | $3.72 | $4.47 |
Pacific Source Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Providence Setting Facility Modifier None Typical Low $2.57 Median $3.24 Typical High $4.27 | Facility | None | $2.57 | $3.24 | $4.27 |
Providence Setting Professional Modifier None Typical Low $2.29 Median $3.31 Typical High $79.43 | Professional | None | $2.29 | $3.31 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.89 Median $4.27 Typical High $4.27 | Professional | None | $3.89 | $4.27 | $4.27 |
United Setting Professional Modifier None Typical Low $1.74 Median $1.91 Typical High $3.72 | Professional | None | $1.74 | $1.91 | $3.72 |
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 $1.38 Typical High $1.38 | Professional | 52 · Reduced service | $1.38 | $1.38 | $1.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 53 · Discontinued | $0.55 | $0.55 | $0.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $0.42 |
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 $1.38 Typical High $1.38 | Professional | 52 · Reduced service | $1.38 | $1.38 | $1.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 53 · Discontinued | $0.55 | $0.55 | $0.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $0.42 |
Moda Health 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 |
Where Oregon sits
The same service costs 2.1 times more in Montana 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· 16th of 51
$3.24
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.