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 $0.44 Median $0.45 Typical High $0.62 | Professional | None | $0.44 | $0.45 | $0.62 |
Cigna Setting Facility Modifier None Typical Low $0.52 Median $0.59 Typical High $0.95 | Facility | None | $0.52 | $0.59 | $0.95 |
Cigna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.50 | Professional | None | $0.44 | $0.44 | $0.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.33 Median $0.72 Typical High $0.85 | Professional | None | $0.33 | $0.72 | $0.85 |
Moda Health Setting Facility Modifier None Typical Low $0.24 Median $0.44 Typical High $0.71 | Facility | None | $0.24 | $0.44 | $0.71 |
Moda Health Setting Professional Modifier None Typical Low $0.42 Median $0.47 Typical High $0.62 | Professional | None | $0.42 | $0.47 | $0.62 |
Pacific Source Setting Facility Modifier None Typical Low $0.24 Median $0.49 Typical High $0.81 | Facility | None | $0.24 | $0.49 | $0.81 |
Providence Setting Facility Modifier None Typical Low $0.44 Median $0.63 Typical High $0.95 | Facility | None | $0.44 | $0.63 | $0.95 |
Providence Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.50 | Professional | None | $0.44 | $0.44 | $0.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.51 | Professional | None | $0.44 | $0.44 | $0.51 |
United Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.52 | Professional | None | $0.44 | $0.44 | $0.52 |
5 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 $0.22 Median $0.22 Typical High $0.25 | Professional | 52 · Reduced service | $0.22 | $0.22 | $0.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.22 Median $0.22 Typical High $0.24 | Professional | 52 · Reduced service | $0.22 | $0.22 | $0.24 |
Where Oregon sits
The same service costs 1.6 times more in Alaska than in Montana. 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
$0.44
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.