How much rates vary
Facilitymedian $251 · 10th to 90th $214 to $457Professionalmedian $229 · 10th to 90th $219 to $269
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 $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $478.63 | Facility | None | $223.87 | $363.08 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | None | $229.09 | $229.09 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $478.63 Typical High $575.44 | Professional | None | $229.09 | $478.63 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $281.84 | Facility | None | $223.87 | $229.09 | $281.84 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $263.03 | Professional | None | $223.87 | $229.09 | $263.03 |
Pacific Source Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $446.68 | Facility | None | $213.80 | $218.78 | $446.68 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $346.74 Typical High $478.63 | Facility | None | $229.09 | $346.74 | $478.63 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $229.09 Typical High $288.40 | Professional | None | $79.43 | $229.09 | $288.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $223.87 Median $309.03 Typical High $660.69 | Facility | None | $223.87 | $309.03 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | None | $218.78 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $257.04 | Professional | None | $223.87 | $223.87 | $257.04 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $44.67 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
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
$229
AK $282TN $229
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.