How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $4Professionalmedian $1 · 10th to 90th $1 to $2
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 $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Facility Modifier None Typical Low $1.45 Median $1.74 Typical High $2.51 | Facility | None | $1.45 | $1.74 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.26 | Professional | None | $1.10 | $1.10 | $1.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.66 Median $2.29 Typical High $3.31 | Professional | None | $1.66 | $2.29 | $3.31 |
Moda Health Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $3.80 | Facility | None | $1.10 | $1.10 | $3.80 |
Moda Health Setting Professional Modifier None Typical Low $1.02 Median $1.10 Typical High $1.32 | Professional | None | $1.02 | $1.10 | $1.32 |
Moda Health Setting Professional Modifier EC · Anemia drug, other cause Typical Low $5.13 Median $8.51 Typical High $9.77 | Professional | EC · Anemia drug, other cause | $5.13 | $8.51 | $9.77 |
Moda Health Setting Professional Modifier JA · Given by IV Typical Low $3.89 Median $8.13 Typical High $9.77 | Professional | JA · Given by IV | $3.89 | $8.13 | $9.77 |
Pacific Source Setting Facility Modifier None Typical Low $1.45 Median $1.70 Typical High $3.02 | Facility | None | $1.45 | $1.70 | $3.02 |
Providence Setting Facility Modifier None Typical Low $1.10 Median $1.74 Typical High $3.80 | Facility | None | $1.10 | $1.74 | $3.80 |
Providence Setting Professional Modifier None Typical Low $1.10 Median $1.17 Typical High $1.51 | Professional | None | $1.10 | $1.17 | $1.51 |
Regence BlueShield Setting Facility Modifier None Typical Low $1.82 Median $3.02 Typical High $5.37 | Facility | None | $1.82 | $3.02 | $5.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.05 Median $1.10 Typical High $1.10 | Professional | None | $1.05 | $1.10 | $1.10 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.17 | Professional | None | $1.02 | $1.02 | $1.17 |
10 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 $0.55 Median $0.55 Typical High $0.55 | Professional | 52 · Reduced service | $0.55 | $0.55 | $0.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.17 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 52 · Reduced service | $0.52 | $0.52 | $0.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 53 · Discontinued | $0.21 | $0.21 | $0.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.16 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.16 |
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 |
Moda Health Setting Professional Modifier JB · Given under the skin Typical Low $4.17 Median $8.32 Typical High $9.33 | Professional | JB · Given under the skin | $4.17 | $8.32 | $9.33 |
Moda Health Setting Professional Modifier JZ · No drug discarded Typical Low $8.13 Median $9.33 Typical High $11.48 | Professional | JZ · No drug discarded | $8.13 | $9.33 | $11.48 |
Where Oregon sits
The same service costs 2.7 times more in Wyoming 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· 40th of 51
$1.10
WY $2.95AL $1.10
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.