How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.46 Median $0.46 Typical High $0.48 | Professional | None | $0.46 | $0.46 | $0.48 |
Cigna Setting Facility Modifier None Typical Low $0.95 Median $0.95 Typical High $0.95 | Facility | None | $0.95 | $0.95 | $0.95 |
Cigna Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.23 Median $1.48 Typical High $1.95 | Professional | None | $1.23 | $1.48 | $1.95 |
Moda Health Setting Facility Modifier None Typical Low $0.29 Median $0.62 Typical High $0.66 | Facility | None | $0.29 | $0.62 | $0.66 |
Moda Health Setting Professional Modifier None Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | None | $0.46 | $0.46 | $0.46 |
Providence Setting Facility Modifier None Typical Low $0.46 Median $0.66 Typical High $0.95 | Facility | None | $0.46 | $0.66 | $0.95 |
Providence Setting Professional Modifier None Typical Low $0.48 Median $0.59 Typical High $70.79 | Professional | None | $0.48 | $0.59 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.45 Median $1.51 Typical High $1.51 | Professional | None | $1.45 | $1.51 | $1.51 |
United Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.54 | Professional | None | $0.47 | $0.47 | $0.54 |
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 $0.23 Median $0.23 Typical High $0.24 | Professional | 52 · Reduced service | $0.23 | $0.23 | $0.24 |
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 $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 52 · Reduced service | $0.23 | $0.23 | $0.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.09 |
Moda Health 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 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Oregon sits
The same service costs 2.3 times more in Montana than in Michigan. 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· 28th of 51
$0.48
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.