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 $0.85 Typical High $0.89 | Professional | None | $0.85 | $0.85 | $0.89 |
Cigna Setting Facility Modifier None Typical Low $1.12 Median $1.15 Typical High $1.91 | Facility | None | $1.12 | $1.15 | $1.91 |
Cigna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.95 | Professional | None | $0.85 | $0.85 | $0.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.48 Median $2.04 Typical High $2.51 | Professional | None | $1.48 | $2.04 | $2.51 |
Moda Health Setting Facility Modifier None Typical Low $0.85 Median $0.91 Typical High $3.72 | Facility | None | $0.85 | $0.91 | $3.72 |
Moda Health Setting Professional Modifier None Typical Low $0.85 Median $0.91 Typical High $1.07 | Professional | None | $0.85 | $0.91 | $1.07 |
Pacific Source Setting Facility Modifier None Typical Low $0.74 Median $0.79 Typical High $1.66 | Facility | None | $0.74 | $0.79 | $1.66 |
Providence Setting Facility Modifier None Typical Low $0.85 Median $1.23 Typical High $3.72 | Facility | None | $0.85 | $1.23 | $3.72 |
Providence Setting Professional Modifier None Typical Low $0.85 Median $0.93 Typical High $1.07 | Professional | None | $0.85 | $0.93 | $1.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.38 Median $1.91 Typical High $3.24 | Facility | None | $1.38 | $1.91 | $3.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.81 Median $0.85 Typical High $0.85 | Professional | None | $0.81 | $0.85 | $0.85 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.15 | Professional | None | $1.00 | $1.00 | $1.15 |
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 $0.43 Median $0.43 Typical High $0.45 | Professional | 52 · Reduced service | $0.43 | $0.43 | $0.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.18 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.14 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.51 Median $0.51 Typical High $0.51 | Professional | 52 · Reduced service | $0.51 | $0.51 | $0.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 53 · Discontinued | $0.20 | $0.20 | $0.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Where Oregon sits
The same service costs 3.7 times more in North Carolina than in Virginia. 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· 36th of 51
$0.85
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.