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 $6.46 Median $6.46 Typical High $7.76 | Facility | None | $6.46 | $6.46 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.61 | Professional | None | $5.25 | $5.25 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $11.22 Typical High $13.80 | Facility | None | $5.75 | $11.22 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.03 | Professional | None | $5.25 | $5.25 | $6.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.03 Median $10.96 Typical High $14.79 | Professional | None | $6.03 | $10.96 | $14.79 |
Moda Health Setting Facility Modifier None Typical Low $5.25 Median $6.31 Typical High $9.77 | Facility | None | $5.25 | $6.31 | $9.77 |
Moda Health Setting Professional Modifier None Typical Low $4.90 Median $5.25 Typical High $6.61 | Professional | None | $4.90 | $5.25 | $6.61 |
Pacific Source Setting Facility Modifier None Typical Low $6.76 Median $8.32 Typical High $13.80 | Facility | None | $6.76 | $8.32 | $13.80 |
Providence Setting Facility Modifier None Typical Low $6.92 Median $7.94 Typical High $13.80 | Facility | None | $6.92 | $7.94 | $13.80 |
Providence Setting Professional Modifier None Typical Low $5.25 Median $6.46 Typical High $8.32 | Professional | None | $5.25 | $6.46 | $8.32 |
Regence BlueShield Setting Facility Modifier None Typical Low $10.47 Median $14.13 Typical High $31.62 | Facility | None | $10.47 | $14.13 | $31.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.01 Median $5.25 Typical High $5.25 | Professional | None | $5.01 | $5.25 | $5.25 |
United Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.62 | Professional | None | $4.90 | $4.90 | $5.62 |
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 $2.63 Median $2.63 Typical High $2.63 | Professional | 52 · Reduced service | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 52 · Reduced service | $2.45 | $2.45 | $2.45 |
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 $0.74 Median $0.74 Typical High $0.74 | Professional | 55 · Aftercare only | $0.74 | $0.74 | $0.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.49 | $0.49 | $0.49 |
Where Oregon sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 48th of 51
$5.25
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.