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 $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $7.24 Median $13.49 Typical High $18.62 | Facility | None | $7.24 | $13.49 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $9.33 | Professional | None | $8.71 | $8.71 | $9.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.00 Median $18.20 Typical High $22.39 | Professional | None | $10.00 | $18.20 | $22.39 |
Moda Health Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $20.89 | Facility | None | $8.71 | $8.71 | $20.89 |
Moda Health Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $10.00 | Professional | None | $8.71 | $8.71 | $10.00 |
Pacific Source Setting Facility Modifier None Typical Low $7.94 Median $9.77 Typical High $16.22 | Facility | None | $7.94 | $9.77 | $16.22 |
Providence Setting Facility Modifier None Typical Low $8.71 Median $13.49 Typical High $20.89 | Facility | None | $8.71 | $13.49 | $20.89 |
Providence Setting Professional Modifier None Typical Low $8.71 Median $10.00 Typical High $79.43 | Professional | None | $8.71 | $10.00 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $8.13 Median $12.02 Typical High $25.70 | Facility | None | $8.13 | $12.02 | $25.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $8.32 Median $8.71 Typical High $8.71 | Professional | None | $8.32 | $8.71 | $8.71 |
United Setting Facility Modifier None Typical Low $8.71 Median $17.78 Typical High $20.89 | Facility | None | $8.71 | $17.78 | $20.89 |
United Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $10.00 | Professional | None | $8.71 | $8.71 | $10.00 |
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 $4.37 Median $4.37 Typical High $4.37 | Professional | 52 · Reduced service | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $0.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.74 | $1.74 | $1.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.85 |
Where Oregon sits
The same service costs 1.9 times more in Wyoming than in Mississippi. 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· 24th of 51
$8.71
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.