How much rates vary
Facilitymedian $219 · 10th to 90th $191 to $407Professionalmedian $204 · 10th to 90th $200 to $251
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 $204.17 Median $204.17 Typical High $223.87 | Professional | None | $204.17 | $204.17 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $436.52 | Facility | None | $199.53 | $331.13 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | None | $204.17 | $204.17 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $436.52 Typical High $512.86 | Professional | None | $204.17 | $436.52 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $257.04 | Facility | None | $199.53 | $204.17 | $257.04 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $245.47 | Professional | None | $199.53 | $204.17 | $245.47 |
Pacific Source Setting Facility Modifier None Typical Low $190.55 Median $199.53 Typical High $407.38 | Facility | None | $190.55 | $199.53 | $407.38 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $234.42 Typical High $389.05 | Facility | None | $204.17 | $234.42 | $389.05 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $204.17 Typical High $263.03 | Professional | None | $79.43 | $204.17 | $263.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $204.17 Median $275.42 Typical High $588.84 | Facility | None | $204.17 | $275.42 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | None | $190.55 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | None | $199.53 | $199.53 | $234.42 |
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 $102.33 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $40.74 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $19.95 |
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· 36th of 51
$204
AK $251NJ $204
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.