How much rates vary
Facilitymedian $63 · 10th to 90th $51 to $120Professionalmedian $58 · 10th to 90th $55 to $72
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 $70.79 Median $85.11 Typical High $134.90 | Facility | None | $70.79 | $85.11 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $72.44 | Professional | None | $57.54 | $57.54 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $87.10 Typical High $120.23 | Facility | None | $54.95 | $87.10 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | None | $57.54 | $57.54 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $154.88 | Professional | None | $79.43 | $123.03 | $154.88 |
Moda Health Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $134.90 | Facility | None | $57.54 | $63.10 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $70.79 | Professional | None | $54.95 | $57.54 | $70.79 |
Pacific Source Setting Facility Modifier None Typical Low $51.29 Median $54.95 Typical High $114.82 | Facility | None | $51.29 | $54.95 | $114.82 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $107.15 | Facility | None | $56.23 | $63.10 | $107.15 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $64.57 Typical High $79.43 | Professional | None | $57.54 | $64.57 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $54.95 Median $74.13 Typical High $158.49 | Facility | None | $54.95 | $74.13 | $158.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | None | $52.48 | $57.54 | $57.54 |
United Setting Facility Modifier None Typical Low $57.54 Median $117.49 Typical High $138.04 | Facility | None | $57.54 | $117.49 | $138.04 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $63.10 | Professional | None | $54.95 | $54.95 | $63.10 |
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 $28.84 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.48 |
Aetna 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 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $5.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $27.54 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.96 | $10.96 | $10.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
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
$57.54
AK $70.79NJ $57.54
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.