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 Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $4.27 | Facility | None | $3.55 | $3.55 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.63 | Professional | None | $2.88 | $2.88 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $4.37 Median $4.90 Typical High $6.17 | Facility | None | $4.37 | $4.90 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.16 | Professional | None | $2.88 | $2.88 | $3.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.79 Median $7.24 Typical High $8.71 | Professional | None | $4.79 | $7.24 | $8.71 |
Moda Health Setting Facility Modifier None Typical Low $2.88 Median $3.47 Typical High $30.90 | Facility | None | $2.88 | $3.47 | $30.90 |
Moda Health Setting Professional Modifier None Typical Low $2.88 Median $3.24 Typical High $3.72 | Professional | None | $2.88 | $3.24 | $3.72 |
Pacific Source Setting Facility Modifier None Typical Low $3.16 Median $4.68 Typical High $6.61 | Facility | None | $3.16 | $4.68 | $6.61 |
Providence Setting Facility Modifier None Typical Low $2.88 Median $4.90 Typical High $13.18 | Facility | None | $2.88 | $4.90 | $13.18 |
Providence Setting Professional Modifier None Typical Low $2.88 Median $3.55 Typical High $3.98 | Professional | None | $2.88 | $3.55 | $3.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.75 Median $2.88 Typical High $2.88 | Professional | None | $2.75 | $2.88 | $2.88 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.72 | Professional | None | $3.24 | $3.24 | $3.72 |
9 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 $1.45 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $0.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.32 |
Moda Health Setting Professional Modifier JZ · No drug discarded Typical Low $3.63 Median $5.50 Typical High $10.47 | Professional | JZ · No drug discarded | $3.63 | $5.50 | $10.47 |
Where Oregon sits
The same service costs 3.1 times more in Wyoming 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· 45th of 51
$2.88
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.