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 $4.27 Median $4.27 Typical High $4.37 | Professional | None | $4.27 | $4.27 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $6.46 Median $10.96 Typical High $13.18 | Facility | None | $6.46 | $10.96 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.01 | Professional | None | $4.27 | $4.27 | $5.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $10.96 Typical High $16.98 | Professional | None | $5.01 | $10.96 | $16.98 |
Moda Health Setting Facility Modifier None Typical Low $4.27 Median $4.57 Typical High $20.42 | Facility | None | $4.27 | $4.57 | $20.42 |
Moda Health Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $5.50 | Professional | None | $4.27 | $5.01 | $5.50 |
Pacific Source Setting Facility Modifier None Typical Low $7.76 Median $9.55 Typical High $15.85 | Facility | None | $7.76 | $9.55 | $15.85 |
Providence Setting Facility Modifier None Typical Low $4.27 Median $9.77 Typical High $28.18 | Facility | None | $4.27 | $9.77 | $28.18 |
Providence Setting Professional Modifier None Typical Low $4.27 Median $5.50 Typical High $8.13 | Professional | None | $4.27 | $5.50 | $8.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.07 Median $4.27 Typical High $4.27 | Professional | None | $4.07 | $4.27 | $4.27 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.75 | Professional | None | $5.01 | $5.01 | $5.75 |
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 $2.14 Median $2.14 Typical High $2.19 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.87 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.43 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 52 · Reduced service | $2.51 | $2.51 | $2.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 53 · Discontinued | $1.00 | $1.00 | $1.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $0.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.50 | $0.50 | $0.50 |
Where Oregon sits
The same service costs 5.1 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· 43rd of 51
$4.27
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.