How much rates vary
Facilitymedian $339 · 10th to 90th $257 to $589Professionalmedian $282 · 10th to 90th $257 to $339
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 $281.84 Median $281.84 Typical High $309.03 | Professional | None | $281.84 | $281.84 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $588.84 | Facility | None | $269.15 | $426.58 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $302.00 | Professional | None | $281.84 | $281.84 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $724.44 | Professional | None | $323.59 | $575.44 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $281.84 Typical High $346.74 | Facility | None | $269.15 | $281.84 | $346.74 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $338.84 | Professional | None | $269.15 | $281.84 | $338.84 |
Pacific Source Setting Facility Modifier None Typical Low $257.04 Median $323.59 Typical High $537.03 | Facility | None | $257.04 | $323.59 | $537.03 |
Providence Setting Facility Modifier None Typical Low $281.84 Median $416.87 Typical High $588.84 | Facility | None | $281.84 | $416.87 | $588.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $281.84 Typical High $354.81 | Professional | None | $79.43 | $281.84 | $354.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $223.87 Median $331.13 Typical High $707.95 | Facility | None | $223.87 | $331.13 | $707.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | None | $257.04 | $281.84 | $281.84 |
United Setting Facility Modifier None Typical Low $281.84 Median $575.44 Typical High $676.08 | Facility | None | $281.84 | $575.44 | $676.08 |
United Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $309.03 | Professional | None | $269.15 | $269.15 | $309.03 |
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 $138.04 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $134.90 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $53.70 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $26.92 |
Where Oregon sits
Rates are fairly even across states for this service. 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· 17th of 51
$282
AK $339NC $275
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.