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 $3.98 Median $3.98 Typical High $4.27 | Professional | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.71 Median $10.47 Typical High $151.36 | Professional | None | $8.71 | $10.47 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $3.98 Median $5.25 Typical High $5.75 | Facility | None | $3.98 | $5.25 | $5.75 |
Moda Health Setting Professional Modifier None Typical Low $3.98 Median $5.01 Typical High $5.50 | Professional | None | $3.98 | $5.01 | $5.50 |
Pacific Source Setting Facility Modifier None Typical Low $4.79 Median $5.25 Typical High $5.37 | Facility | None | $4.79 | $5.25 | $5.37 |
Providence Setting Facility Modifier None Typical Low $4.57 Median $4.68 Typical High $6.61 | Facility | None | $4.57 | $4.68 | $6.61 |
Providence Setting Professional Modifier None Typical Low $2.24 Median $4.47 Typical High $79.43 | Professional | None | $2.24 | $4.47 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.75 Median $6.03 Typical High $6.03 | Professional | None | $5.75 | $6.03 | $6.03 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.29 Typical High $4.47 | Professional | None | $1.78 | $2.29 | $4.47 |
10 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 $2.00 Median $2.00 Typical High $2.00 | Professional | 52 · Reduced service | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 53 · Discontinued | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 54 · Surgery only | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | 55 · Aftercare only | $0.60 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.40 | $0.40 | $0.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 52 · Reduced service | $2.00 | $2.00 | $2.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 53 · Discontinued | $0.79 | $0.79 | $0.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 54 · Surgery only | $3.02 | $3.02 | $3.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | 55 · Aftercare only | $0.60 | $0.60 | $0.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.40 | $0.40 | $0.40 |
Where Oregon sits
The same service costs 3.8 times more in Rhode Island than in New York. 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· 23rd of 51
$3.98
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.