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 $8.91 Median $11.48 Typical High $11.48 | Professional | None | $8.91 | $11.48 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.02 Median $30.90 Typical High $38.02 | Professional | None | $12.02 | $30.90 | $38.02 |
Moda Health Setting Facility Modifier None Typical Low $11.22 Median $13.80 Typical High $16.22 | Facility | None | $11.22 | $13.80 | $16.22 |
Moda Health Setting Professional Modifier None Typical Low $11.48 Median $14.79 Typical High $16.22 | Professional | None | $11.48 | $14.79 | $16.22 |
Pacific Source Setting Facility Modifier None Typical Low $12.59 Median $15.49 Typical High $15.85 | Facility | None | $12.59 | $15.49 | $15.85 |
Providence Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $17.78 | Facility | None | $9.55 | $13.49 | $17.78 |
Providence Setting Professional Modifier None Typical Low $8.13 Median $13.80 Typical High $79.43 | Professional | None | $8.13 | $13.80 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $16.22 Median $17.78 Typical High $17.78 | Professional | None | $16.22 | $17.78 | $17.78 |
United Setting Professional Modifier None Typical Low $6.17 Median $6.76 Typical High $13.18 | Professional | None | $6.17 | $6.76 | $13.18 |
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 $1.70 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.70 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.15 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.12 | $1.15 | $1.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.70 | $1.74 | $1.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.15 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.12 | $1.15 | $1.15 |
Where Oregon sits
The same service costs 2.2 times more in Kansas 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
$12.59
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.