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 $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
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 $0.71 Median $0.83 Typical High $1.00 | Facility | None | $0.71 | $0.83 | $1.00 |
Moda Health Setting Professional Modifier None Typical Low $0.71 Median $0.76 Typical High $0.95 | Professional | None | $0.71 | $0.76 | $0.95 |
Pacific Source Setting Facility Modifier None Typical Low $0.74 Median $0.93 Typical High $0.95 | Facility | None | $0.74 | $0.93 | $0.95 |
Pacific Source Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | None | $0.95 | $0.95 | $0.95 |
Providence Setting Facility Modifier None Typical Low $0.81 Median $0.83 Typical High $1.15 | Facility | None | $0.81 | $0.83 | $1.15 |
Providence Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $79.43 | Professional | None | $0.49 | $0.49 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.02 Median $1.07 Typical High $1.07 | Professional | None | $1.02 | $1.07 | $1.07 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.41 Typical High $0.78 | Professional | None | $0.32 | $0.41 | $0.78 |
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 $0.35 Median $0.35 Typical High $0.35 | Professional | 52 · Reduced service | $0.35 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 52 · Reduced service | $0.35 | $0.35 | $0.35 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.14 | $0.14 | $0.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
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
$0.71
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.