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 $2.45 Median $3.24 Typical High $3.24 | Professional | None | $2.45 | $3.24 | $3.24 |
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 $3.39 Median $8.51 Typical High $10.47 | Professional | None | $3.39 | $8.51 | $10.47 |
Moda Health Setting Facility Modifier None Typical Low $3.24 Median $3.47 Typical High $4.57 | Facility | None | $3.24 | $3.47 | $4.57 |
Moda Health Setting Professional Modifier None Typical Low $3.24 Median $4.07 Typical High $4.57 | Professional | None | $3.24 | $4.07 | $4.57 |
Pacific Source Setting Facility Modifier None Typical Low $3.80 Median $3.98 Typical High $4.47 | Facility | None | $3.80 | $3.98 | $4.47 |
Pacific Source Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.47 | Professional | None | $4.37 | $4.37 | $4.47 |
Providence Setting Facility Modifier None Typical Low $2.69 Median $3.80 Typical High $5.01 | Facility | None | $2.69 | $3.80 | $5.01 |
Providence Setting Professional Modifier None Typical Low $2.29 Median $3.89 Typical High $79.43 | Professional | None | $2.29 | $3.89 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.57 Median $5.01 Typical High $5.01 | Professional | None | $4.57 | $5.01 | $5.01 |
United Setting Professional Modifier None Typical Low $1.74 Median $1.86 Typical High $3.72 | Professional | None | $1.74 | $1.86 | $3.72 |
4 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 55 · Aftercare only Typical Low $0.47 Median $0.49 Typical High $0.49 | Professional | 55 · Aftercare only | $0.47 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.31 | $0.33 | $0.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $0.49 Typical High $0.49 | Professional | 55 · Aftercare only | $0.47 | $0.49 | $0.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.31 | $0.33 | $0.33 |
Where Oregon sits
The same service costs 2.3 times more in Hawaii 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· 11th of 51
$3.80
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.