How much rates vary
Facilitymedian $81 · 10th to 90th $56 to $135Professionalmedian $60 · 10th to 90th $56 to $78
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 Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Professional | None | $60.26 | $60.26 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $128.82 | Facility | None | $56.23 | $91.20 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | None | $60.26 | $60.26 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $158.49 | Professional | None | $79.43 | $123.03 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $64.57 Typical High $134.90 | Facility | None | $60.26 | $64.57 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $75.86 | Professional | None | $56.23 | $60.26 | $75.86 |
Pacific Source Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $114.82 | Facility | None | $52.48 | $69.18 | $114.82 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $128.82 | Facility | None | $60.26 | $89.13 | $128.82 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $79.43 | Professional | None | $60.26 | $64.57 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $50.12 Median $70.79 Typical High $151.36 | Facility | None | $50.12 | $70.79 | $151.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $60.26 | Professional | None | $54.95 | $60.26 | $60.26 |
United Setting Facility Modifier None Typical Low $60.26 Median $123.03 Typical High $144.54 | Facility | None | $60.26 | $123.03 | $144.54 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | None | $56.23 | $56.23 | $64.57 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.62 |
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· 25th of 51
$60.26
AK $74.13OK $58.88
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.