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 $33.11 Median $33.11 Typical High $34.67 | Professional | None | $33.11 | $33.11 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier RR · Rental Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $100.00 | $100.00 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $165.96 | Professional | None | $100.00 | $125.89 | $165.96 |
Moda Health Setting Facility Modifier None Typical Low $33.11 Median $51.29 Typical High $81.28 | Facility | None | $33.11 | $51.29 | $81.28 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $56.23 Typical High $77.62 | Professional | None | $33.11 | $56.23 | $77.62 |
Pacific Source Setting Facility Modifier None Typical Low $57.54 Median $61.66 Typical High $79.43 | Facility | None | $57.54 | $61.66 | $79.43 |
Pacific Source Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $79.43 | Professional | None | $57.54 | $79.43 | $79.43 |
Providence Setting Facility Modifier None Typical Low $40.74 Median $42.66 Typical High $74.13 | Facility | None | $40.74 | $42.66 | $74.13 |
Providence Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $79.43 | Professional | None | $34.67 | $44.67 | $79.43 |
Providence Setting Professional Modifier RR · Rental Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $100.00 | $100.00 | $100.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $46.77 Median $100.00 Typical High $223.87 | Facility | None | $46.77 | $100.00 | $223.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $75.86 Typical High $79.43 | Professional | None | $66.07 | $75.86 | $79.43 |
United Setting Professional Modifier None Typical Low $21.38 Median $30.20 Typical High $60.26 | Professional | None | $21.38 | $30.20 | $60.26 |
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 $5.01 Median $5.01 Typical High $5.25 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $5.01 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.31 |
Where Oregon sits
The same service costs 6.6 times more in Hawaii than in Wyoming. 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· 10th of 51
$56.23
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.