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 $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.57 Median $13.18 Typical High $16.22 | Professional | None | $4.57 | $13.18 | $16.22 |
Moda Health Setting Facility Modifier None Typical Low $3.98 Median $4.90 Typical High $5.75 | Facility | None | $3.98 | $4.90 | $5.75 |
Moda Health Setting Professional Modifier None Typical Low $4.07 Median $5.25 Typical High $5.75 | Professional | None | $4.07 | $5.25 | $5.75 |
Pacific Source Setting Facility Modifier None Typical Low $4.47 Median $5.50 Typical High $5.62 | Facility | None | $4.47 | $5.50 | $5.62 |
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 $3.80 Median $4.79 Typical High $6.31 | Facility | None | $3.80 | $4.79 | $6.31 |
Providence Setting Professional Modifier None Typical Low $3.39 Median $4.90 Typical High $79.43 | Professional | None | $3.39 | $4.90 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $4.47 Median $8.91 Typical High $21.88 | Facility | None | $4.47 | $8.91 | $21.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.75 Median $6.31 Typical High $6.31 | Professional | None | $5.75 | $6.31 | $6.31 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.82 Typical High $5.50 | Professional | None | $2.57 | $2.82 | $5.50 |
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 $0.62 Median $0.62 Typical High $0.62 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $0.41 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $0.41 |
Where Oregon sits
The same service costs 2.2 times more in Minnesota 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· 18th of 51
$4.79
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.