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 $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.74 Median $2.24 Typical High $151.36 | Professional | None | $1.74 | $2.24 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $0.81 Median $0.95 Typical High $1.23 | Facility | None | $0.81 | $0.95 | $1.23 |
Moda Health Setting Professional Modifier None Typical Low $0.79 Median $0.85 Typical High $1.10 | Professional | None | $0.79 | $0.85 | $1.10 |
Pacific Source Setting Facility Modifier None Typical Low $0.85 Median $1.07 Typical High $1.10 | Facility | None | $0.85 | $1.07 | $1.10 |
Pacific Source Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Providence Setting Facility Modifier None Typical Low $0.93 Median $0.95 Typical High $1.35 | Facility | None | $0.93 | $0.95 | $1.35 |
Providence Setting Professional Modifier None Typical Low $0.55 Median $0.91 Typical High $79.43 | Professional | None | $0.55 | $0.91 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.17 Median $1.23 Typical High $1.23 | Professional | None | $1.17 | $1.23 | $1.23 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.46 Typical High $0.89 | Professional | None | $0.36 | $0.46 | $0.89 |
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 $0.40 Median $0.40 Typical High $0.40 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.16 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
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
$0.81
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.