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 $0.85 Median $2.09 Typical High $2.09 | Professional | None | $0.85 | $2.09 | $2.09 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.74 | Professional | None | $1.48 | $1.48 | $1.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.34 Median $5.50 Typical High $6.61 | Professional | None | $2.34 | $5.50 | $6.61 |
Moda Health Setting Facility Modifier None Typical Low $2.09 Median $2.29 Typical High $2.95 | Facility | None | $2.09 | $2.29 | $2.95 |
Moda Health Setting Professional Modifier None Typical Low $2.09 Median $2.69 Typical High $2.95 | Professional | None | $2.09 | $2.69 | $2.95 |
Pacific Source Setting Facility Modifier None Typical Low $2.29 Median $2.82 Typical High $2.88 | Facility | None | $2.29 | $2.82 | $2.88 |
Pacific Source Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Providence Setting Facility Modifier None Typical Low $1.74 Median $2.45 Typical High $3.24 | Facility | None | $1.74 | $2.45 | $3.24 |
Providence Setting Professional Modifier None Typical Low $1.48 Median $2.51 Typical High $79.43 | Professional | None | $1.48 | $2.51 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.95 Median $3.24 Typical High $3.24 | Professional | None | $2.95 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $1.12 Median $1.23 Typical High $2.40 | Professional | None | $1.12 | $1.23 | $2.40 |
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 $1.02 Median $1.07 Typical High $1.07 | Professional | 52 · Reduced service | $1.02 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.42 Typical High $0.42 | Professional | 53 · Discontinued | $0.41 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.32 Typical High $0.32 | Professional | 55 · Aftercare only | $0.31 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.20 | $0.21 | $0.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.02 Median $1.07 Typical High $1.07 | Professional | 52 · Reduced service | $1.02 | $1.07 | $1.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.42 Typical High $0.42 | Professional | 53 · Discontinued | $0.41 | $0.42 | $0.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.32 Typical High $0.32 | Professional | 55 · Aftercare only | $0.31 | $0.32 | $0.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.20 | $0.21 | $0.21 |
Where Oregon sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 16th of 51
$2.34
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.