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 $1.78 Median $1.91 Typical High $1.91 | Professional | None | $1.78 | $1.91 | $1.91 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.37 Median $5.25 Typical High $151.36 | Professional | None | $4.37 | $5.25 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $2.00 Median $2.29 Typical High $2.75 | Facility | None | $2.00 | $2.29 | $2.75 |
Moda Health Setting Professional Modifier None Typical Low $1.91 Median $2.09 Typical High $2.63 | Professional | None | $1.91 | $2.09 | $2.63 |
Pacific Source Setting Facility Modifier None Typical Low $2.09 Median $2.51 Typical High $2.63 | Facility | None | $2.09 | $2.51 | $2.63 |
Pacific Source Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
Providence Setting Facility Modifier None Typical Low $2.24 Median $2.29 Typical High $3.16 | Facility | None | $2.24 | $2.29 | $3.16 |
Providence Setting Professional Modifier None Typical Low $1.32 Median $2.14 Typical High $79.43 | Professional | None | $1.32 | $2.14 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.75 Median $2.95 Typical High $2.95 | Professional | None | $2.75 | $2.95 | $2.95 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.12 Typical High $2.14 | Professional | None | $0.87 | $1.12 | $2.14 |
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 $0.95 Median $0.95 Typical High $0.95 | Professional | 52 · Reduced service | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | 53 · Discontinued | $0.38 | $0.38 | $0.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 52 · Reduced service | $0.95 | $0.95 | $0.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | 53 · Discontinued | $0.38 | $0.38 | $0.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.29 Median $0.29 Typical High $0.29 | Professional | 55 · Aftercare only | $0.29 | $0.29 | $0.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.19 |
Where Oregon sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 20th of 51
$1.95
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.