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 $1.45 Median $1.45 Typical High $1.45 | Professional | None | $1.45 | $1.45 | $1.45 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.95 Median $3.72 Typical High $151.36 | Professional | None | $2.95 | $3.72 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $1.45 Median $1.70 Typical High $2.04 | Facility | None | $1.45 | $1.70 | $2.04 |
Moda Health Setting Professional Modifier None Typical Low $1.45 Median $1.55 Typical High $1.95 | Professional | None | $1.45 | $1.55 | $1.95 |
Pacific Source Setting Facility Modifier None Typical Low $1.55 Median $1.91 Typical High $1.95 | Facility | None | $1.55 | $1.91 | $1.95 |
Pacific Source Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.14 | Professional | None | $1.95 | $1.95 | $2.14 |
Providence Setting Facility Modifier None Typical Low $1.66 Median $1.70 Typical High $2.40 | Facility | None | $1.66 | $1.70 | $2.40 |
Providence Setting Professional Modifier None Typical Low $1.00 Median $1.62 Typical High $79.43 | Professional | None | $1.00 | $1.62 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.09 Median $2.19 Typical High $2.19 | Professional | None | $2.09 | $2.19 | $2.19 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.83 Typical High $1.58 | Professional | None | $0.65 | $0.83 | $1.58 |
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 $0.72 Median $0.72 Typical High $0.72 | Professional | 52 · Reduced service | $0.72 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 52 · Reduced service | $0.72 | $0.72 | $0.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.29 Median $0.29 Typical High $0.29 | Professional | 53 · Discontinued | $0.29 | $0.29 | $0.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
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
$1.45
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.