How much rates vary
Facilitymedian $363 · 10th to 90th $309 to $676Professionalmedian $331 · 10th to 90th $316 to $389
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 $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $707.95 | Facility | None | $323.59 | $524.81 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $354.81 | Professional | None | $331.13 | $331.13 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $691.83 Typical High $831.76 | Professional | None | $331.13 | $691.83 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $331.13 Typical High $457.09 | Facility | None | $323.59 | $331.13 | $457.09 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $380.19 | Professional | None | $323.59 | $331.13 | $380.19 |
Pacific Source Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $660.69 | Facility | None | $309.03 | $316.23 | $660.69 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $707.95 | Facility | None | $331.13 | $501.19 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $331.13 Typical High $416.87 | Professional | None | $79.43 | $331.13 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $446.68 Typical High $954.99 | Facility | None | $323.59 | $446.68 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | None | $316.23 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $331.13 Median $676.08 Typical High $794.33 | Facility | None | $331.13 | $676.08 | $794.33 |
United Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | None | $323.59 | $323.59 | $371.54 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $64.57 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $32.36 |
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· 35th of 51
$331
AK $407VT $331
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.