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 $8.13 Median $10.47 Typical High $10.47 | Professional | None | $8.13 | $10.47 | $10.47 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | None | $8.51 | $8.51 | $10.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.96 Median $32.36 Typical High $39.81 | Professional | None | $10.96 | $32.36 | $39.81 |
Moda Health Setting Facility Modifier None Typical Low $10.00 Median $10.96 Typical High $14.79 | Facility | None | $10.00 | $10.96 | $14.79 |
Moda Health Setting Professional Modifier None Typical Low $10.47 Median $13.18 Typical High $14.45 | Professional | None | $10.47 | $13.18 | $14.45 |
Pacific Source Setting Facility Modifier None Typical Low $11.22 Median $13.80 Typical High $16.60 | Facility | None | $11.22 | $13.80 | $16.60 |
Pacific Source Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $15.49 | Professional | None | $14.13 | $14.13 | $15.49 |
Providence Setting Facility Modifier None Typical Low $10.00 Median $12.02 Typical High $15.85 | Facility | None | $10.00 | $12.02 | $15.85 |
Providence Setting Professional Modifier None Typical Low $8.51 Median $12.30 Typical High $79.43 | Professional | None | $8.51 | $12.30 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $14.79 Median $15.85 Typical High $15.85 | Professional | None | $14.79 | $15.85 | $15.85 |
United Setting Professional Modifier None Typical Low $6.46 Median $7.08 Typical High $13.80 | Professional | None | $6.46 | $7.08 | $13.80 |
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 $1.55 Median $1.55 Typical High $1.55 | Professional | 55 · Aftercare only | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | 55 · Aftercare only | $1.55 | $1.55 | $1.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.05 |
Where Oregon sits
The same service costs 2.3 times more in Montana 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· 16th of 51
$12.30
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.