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 $2.57 Median $3.63 Typical High $3.63 | Professional | None | $2.57 | $3.63 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.07 Median $10.00 Typical High $12.30 | Professional | None | $4.07 | $10.00 | $12.30 |
Moda Health Setting Facility Modifier None Typical Low $3.63 Median $3.98 Typical High $5.13 | Facility | None | $3.63 | $3.98 | $5.13 |
Moda Health Setting Professional Modifier None Typical Low $3.63 Median $4.68 Typical High $5.13 | Professional | None | $3.63 | $4.68 | $5.13 |
Pacific Source Setting Facility Modifier None Typical Low $3.98 Median $4.90 Typical High $5.01 | Facility | None | $3.98 | $4.90 | $5.01 |
Pacific Source Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
Providence Setting Facility Modifier None Typical Low $3.02 Median $4.27 Typical High $5.62 | Facility | None | $3.02 | $4.27 | $5.62 |
Providence Setting Professional Modifier None Typical Low $2.57 Median $4.37 Typical High $79.43 | Professional | None | $2.57 | $4.37 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.13 Median $5.62 Typical High $5.62 | Professional | None | $5.13 | $5.62 | $5.62 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.14 Typical High $4.17 | Professional | None | $1.95 | $2.14 | $4.17 |
4 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 55 · Aftercare only Typical Low $0.52 Median $0.55 Typical High $0.55 | Professional | 55 · Aftercare only | $0.52 | $0.55 | $0.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.35 | $0.37 | $0.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.55 Typical High $0.55 | Professional | 55 · Aftercare only | $0.52 | $0.55 | $0.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.35 | $0.37 | $0.37 |
Where Oregon sits
The same service costs 2.2 times more in Kansas than in Delaware. 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
$4.07
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.