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 $0.56 Median $0.65 Typical High $0.65 | Professional | None | $0.56 | $0.65 | $0.65 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.26 Median $1.48 Typical High $2.14 | Professional | None | $1.26 | $1.48 | $2.14 |
Moda Health Setting Facility Modifier None Typical Low $0.66 Median $0.76 Typical High $0.91 | Facility | None | $0.66 | $0.76 | $0.91 |
Moda Health Setting Professional Modifier None Typical Low $0.65 Median $0.69 Typical High $0.87 | Professional | None | $0.65 | $0.69 | $0.87 |
Pacific Source Setting Facility Modifier None Typical Low $0.69 Median $0.85 Typical High $0.87 | Facility | None | $0.69 | $0.85 | $0.87 |
Providence Setting Facility Modifier None Typical Low $0.76 Median $0.76 Typical High $1.10 | Facility | None | $0.76 | $0.76 | $1.10 |
Providence Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $79.43 | Professional | None | $0.45 | $0.45 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.93 Median $1.00 Typical High $1.00 | Professional | None | $0.93 | $1.00 | $1.00 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.37 Typical High $0.71 | Professional | None | $0.28 | $0.37 | $0.71 |
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 $0.32 Median $0.32 Typical High $0.32 | Professional | 52 · Reduced service | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
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 $0.32 Median $0.32 Typical High $0.32 | Professional | 52 · Reduced service | $0.32 | $0.32 | $0.32 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
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
$0.65
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.