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 $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.62 Median $0.74 Typical High $151.36 | Professional | None | $0.62 | $0.74 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $0.42 Median $0.46 Typical High $0.58 | Facility | None | $0.42 | $0.46 | $0.58 |
Moda Health Setting Professional Modifier None Typical Low $0.40 Median $0.44 Typical High $0.54 | Professional | None | $0.40 | $0.44 | $0.54 |
Pacific Source Setting Facility Modifier None Typical Low $0.45 Median $0.52 Typical High $0.54 | Facility | None | $0.45 | $0.52 | $0.54 |
Pacific Source Setting Professional Modifier None Typical Low $0.54 Median $0.59 Typical High $0.59 | Professional | None | $0.54 | $0.59 | $0.59 |
Providence Setting Facility Modifier None Typical Low $0.46 Median $0.50 Typical High $0.66 | Facility | None | $0.46 | $0.50 | $0.66 |
Providence Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $79.43 | Professional | None | $0.28 | $0.28 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.58 Median $0.62 Typical High $0.62 | Professional | None | $0.58 | $0.62 | $0.62 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.23 Typical High $0.45 | Professional | None | $0.18 | $0.23 | $0.45 |
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 $0.20 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
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· 21st of 51
$0.40
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.