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 $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.92 Median $8.13 Typical High $151.36 | Professional | None | $6.92 | $8.13 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $3.09 Median $4.07 Typical High $4.47 | Facility | None | $3.09 | $4.07 | $4.47 |
Moda Health Setting Professional Modifier None Typical Low $3.09 Median $3.89 Typical High $4.27 | Professional | None | $3.09 | $3.89 | $4.27 |
Pacific Source Setting Facility Modifier None Typical Low $3.80 Median $4.17 Typical High $4.27 | Facility | None | $3.80 | $4.17 | $4.27 |
Providence Setting Facility Modifier None Typical Low $3.63 Median $3.72 Typical High $5.13 | Facility | None | $3.63 | $3.72 | $5.13 |
Providence Setting Professional Modifier None Typical Low $1.78 Median $3.47 Typical High $79.43 | Professional | None | $1.78 | $3.47 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.47 Median $4.79 Typical High $4.79 | Professional | None | $4.47 | $4.79 | $4.79 |
United Setting Professional Modifier None Typical Low $1.41 Median $1.78 Typical High $3.55 | Professional | None | $1.41 | $1.78 | $3.55 |
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 $1.55 Median $1.55 Typical High $1.55 | Professional | 52 · Reduced service | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | 54 · Surgery only | $2.34 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $0.47 Typical High $0.47 | Professional | 55 · Aftercare only | $0.47 | $0.47 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | 52 · Reduced service | $1.55 | $1.55 | $1.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | 54 · Surgery only | $2.34 | $2.34 | $2.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $0.47 Typical High $0.47 | Professional | 55 · Aftercare only | $0.47 | $0.47 | $0.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.31 |
Where Oregon sits
The same service costs 4.0 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
$3.09
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.