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 $6.76 Median $8.71 Typical High $8.71 | Professional | None | $6.76 | $8.71 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $151.36 | Professional | None | $19.50 | $22.91 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $8.71 Median $11.22 Typical High $12.30 | Facility | None | $8.71 | $11.22 | $12.30 |
Moda Health Setting Professional Modifier None Typical Low $8.71 Median $10.72 Typical High $12.02 | Professional | None | $8.71 | $10.72 | $12.02 |
Pacific Source Setting Facility Modifier None Typical Low $10.47 Median $11.48 Typical High $11.75 | Facility | None | $10.47 | $11.48 | $11.75 |
Providence Setting Facility Modifier None Typical Low $10.00 Median $10.23 Typical High $14.45 | Facility | None | $10.00 | $10.23 | $14.45 |
Providence Setting Professional Modifier None Typical Low $4.90 Median $9.55 Typical High $79.43 | Professional | None | $4.90 | $9.55 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.30 Median $13.18 Typical High $13.18 | Professional | None | $12.30 | $13.18 | $13.18 |
United Setting Professional Modifier None Typical Low $3.89 Median $4.90 Typical High $9.77 | Professional | None | $3.89 | $4.90 | $9.77 |
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 $4.27 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.27 |
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 54 · Surgery only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 54 · Surgery only | $6.46 | $6.46 | $6.46 |
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 $0.85 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.85 |
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 54 · Surgery only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 54 · Surgery only | $6.46 | $6.46 | $6.46 |
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 2.9 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
$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.