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 $0.51 Median $0.56 Typical High $0.56 | Professional | None | $0.51 | $0.56 | $0.56 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.26 Median $1.48 Typical High $151.36 | Professional | None | $1.26 | $1.48 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $0.59 Median $0.68 Typical High $0.81 | Facility | None | $0.59 | $0.68 | $0.81 |
Moda Health Setting Professional Modifier None Typical Low $0.58 Median $0.62 Typical High $0.78 | Professional | None | $0.58 | $0.62 | $0.78 |
Pacific Source Setting Facility Modifier None Typical Low $0.63 Median $0.76 Typical High $0.78 | Facility | None | $0.63 | $0.76 | $0.78 |
Pacific Source Setting Professional Modifier None Typical Low $0.63 Median $0.78 Typical High $0.78 | Professional | None | $0.63 | $0.78 | $0.78 |
Providence Setting Facility Modifier None Typical Low $0.68 Median $0.68 Typical High $0.95 | Facility | None | $0.68 | $0.68 | $0.95 |
Providence Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $79.43 | Professional | None | $0.40 | $0.40 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.83 Median $0.87 Typical High $0.87 | Professional | None | $0.83 | $0.87 | $0.87 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.33 Typical High $0.63 | Professional | None | $0.26 | $0.33 | $0.63 |
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 $0.28 Median $0.28 Typical High $0.28 | Professional | 52 · Reduced service | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.29 Median $0.29 Typical High $0.29 | Professional | 52 · Reduced service | $0.29 | $0.29 | $0.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where Oregon sits
The same service costs 2.6 times more in Hawaii than in Utah. 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
$0.58
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.