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 $11.22 Median $11.22 Typical High $14.79 | Professional | None | $11.22 | $11.22 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $151.36 | Professional | None | $24.55 | $28.84 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $11.22 Median $14.79 Typical High $15.85 | Facility | None | $11.22 | $14.79 | $15.85 |
Moda Health Setting Professional Modifier None Typical Low $11.22 Median $14.79 Typical High $20.42 | Professional | None | $11.22 | $14.79 | $20.42 |
Pacific Source Setting Facility Modifier None Typical Low $13.80 Median $14.79 Typical High $15.14 | Facility | None | $13.80 | $14.79 | $15.14 |
Providence Setting Facility Modifier None Typical Low $12.88 Median $13.18 Typical High $18.62 | Facility | None | $12.88 | $13.18 | $18.62 |
Providence Setting Professional Modifier None Typical Low $6.31 Median $12.59 Typical High $79.43 | Professional | None | $6.31 | $12.59 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $16.22 Median $16.98 Typical High $16.98 | Professional | None | $16.22 | $16.98 | $16.98 |
United Setting Professional Modifier None Typical Low $5.01 Median $6.46 Typical High $12.30 | Professional | None | $5.01 | $6.46 | $12.30 |
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 $5.62 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 54 · Surgery only | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $5.62 | $5.62 | $5.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.24 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 54 · Surgery only | $8.32 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.12 |
Where Oregon sits
The same service costs 4.5 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· 22nd of 51
$12.02
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.