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 $0.76 Median $1.82 Typical High $1.82 | Professional | None | $0.76 | $1.82 | $1.82 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.63 Median $4.47 Typical High $6.46 | Professional | None | $3.63 | $4.47 | $6.46 |
Moda Health Setting Facility Modifier None Typical Low $1.82 Median $2.14 Typical High $2.75 | Facility | None | $1.82 | $2.14 | $2.75 |
Moda Health Setting Professional Modifier None Typical Low $1.82 Median $1.86 Typical High $2.45 | Professional | None | $1.82 | $1.86 | $2.45 |
Pacific Source Setting Facility Modifier None Typical Low $1.95 Median $2.40 Typical High $2.45 | Facility | None | $1.95 | $2.40 | $2.45 |
Pacific Source Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
Providence Setting Facility Modifier None Typical Low $2.09 Median $2.14 Typical High $3.02 | Facility | None | $2.09 | $2.14 | $3.02 |
Providence Setting Professional Modifier None Typical Low $1.26 Median $2.04 Typical High $79.43 | Professional | None | $1.26 | $2.04 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.63 Median $2.75 Typical High $2.75 | Professional | None | $2.63 | $2.75 | $2.75 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.05 Typical High $2.00 | Professional | None | $0.81 | $1.05 | $2.00 |
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 $0.89 Median $0.89 Typical High $0.89 | Professional | 52 · Reduced service | $0.89 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 53 · Discontinued | $0.36 | $0.36 | $0.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 55 · Aftercare only | $0.27 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | 52 · Reduced service | $0.89 | $0.89 | $0.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 53 · Discontinued | $0.36 | $0.36 | $0.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 55 · Aftercare only | $0.27 | $0.27 | $0.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.18 |
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· 19th of 51
$1.82
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.