How much rates vary
Facilitymedian $234 · 10th to 90th $182 to $380Professionalmedian $191 · 10th to 90th $178 to $234
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 $234.42 Median $234.42 Typical High $281.84 | Facility | None | $234.42 | $234.42 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $239.88 | Professional | None | $190.55 | $190.55 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $309.03 Typical High $407.38 | Facility | None | $186.21 | $309.03 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $208.93 | Professional | None | $190.55 | $190.55 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $501.19 | Professional | None | $218.78 | $407.38 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $204.17 Typical High $269.15 | Facility | None | $186.21 | $204.17 | $269.15 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $190.55 Typical High $239.88 | Professional | None | $186.21 | $190.55 | $239.88 |
Pacific Source Setting Facility Modifier None Typical Low $173.78 Median $229.09 Typical High $380.19 | Facility | None | $173.78 | $229.09 | $380.19 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $218.78 Typical High $363.08 | Facility | None | $190.55 | $218.78 | $363.08 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $239.88 | Professional | None | $79.43 | $190.55 | $239.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $186.21 Median $251.19 Typical High $549.54 | Facility | None | $186.21 | $251.19 | $549.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | None | $173.78 | $190.55 | $190.55 |
United Setting Facility Modifier None Typical Low $190.55 Median $389.05 Typical High $457.09 | Facility | None | $190.55 | $389.05 | $457.09 |
United Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | None | $186.21 | $186.21 | $213.80 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $37.15 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $18.62 |
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· 23rd of 51
$191
AK $234MA $191
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.