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 $4.68 Median $6.03 Typical High $6.03 | Professional | None | $4.68 | $6.03 | $6.03 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.88 Median $15.49 Typical High $151.36 | Professional | None | $12.88 | $15.49 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $6.17 Median $7.24 Typical High $8.71 | Facility | None | $6.17 | $7.24 | $8.71 |
Moda Health Setting Professional Modifier None Typical Low $6.03 Median $6.46 Typical High $8.32 | Professional | None | $6.03 | $6.46 | $8.32 |
Pacific Source Setting Facility Modifier None Typical Low $6.61 Median $8.13 Typical High $8.32 | Facility | None | $6.61 | $8.13 | $8.32 |
Pacific Source Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.51 | Professional | None | $8.32 | $8.32 | $8.51 |
Providence Setting Facility Modifier None Typical Low $7.08 Median $7.24 Typical High $10.00 | Facility | None | $7.08 | $7.24 | $10.00 |
Providence Setting Professional Modifier None Typical Low $4.27 Median $6.76 Typical High $79.43 | Professional | None | $4.27 | $6.76 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | None | $8.71 | $9.33 | $9.33 |
United Setting Professional Modifier None Typical Low $2.75 Median $3.47 Typical High $6.76 | Professional | None | $2.75 | $3.47 | $6.76 |
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 $3.02 Median $3.02 Typical High $3.02 | Professional | 52 · Reduced service | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 53 · Discontinued | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 52 · Reduced service | $3.02 | $3.02 | $3.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 53 · Discontinued | $1.20 | $1.20 | $1.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $0.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.62 |
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
$6.17
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.