How much rates vary
Facilitymedian $21 · 10th to 90th $17 to $35Professionalmedian $17 · 10th to 90th $17 to $24
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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $21.88 | Professional | None | $17.38 | $17.38 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $27.54 Typical High $36.31 | Facility | None | $16.98 | $27.54 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $18.62 | Professional | None | $17.38 | $17.38 | $18.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.95 Median $37.15 Typical High $47.86 | Professional | None | $19.95 | $37.15 | $47.86 |
Moda Health Setting Facility Modifier None Typical Low $17.38 Median $18.20 Typical High $24.55 | Facility | None | $17.38 | $18.20 | $24.55 |
Moda Health Setting Professional Modifier None Typical Low $16.98 Median $17.38 Typical High $21.38 | Professional | None | $16.98 | $17.38 | $21.38 |
Pacific Source Setting Facility Modifier None Typical Low $16.22 Median $21.38 Typical High $35.48 | Facility | None | $16.22 | $21.38 | $35.48 |
Providence Setting Facility Modifier None Typical Low $17.38 Median $19.50 Typical High $32.36 | Facility | None | $17.38 | $19.50 | $32.36 |
Providence Setting Professional Modifier None Typical Low $17.38 Median $20.42 Typical High $79.43 | Professional | None | $17.38 | $20.42 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $16.60 Median $22.91 Typical High $50.12 | Facility | None | $16.60 | $22.91 | $50.12 |
Regence BlueShield Setting Professional Modifier None Typical Low $15.85 Median $17.38 Typical High $17.38 | Professional | None | $15.85 | $17.38 | $17.38 |
United Setting Facility Modifier None Typical Low $17.38 Median $35.48 Typical High $41.69 | Facility | None | $17.38 | $35.48 | $41.69 |
United Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $19.50 | Professional | None | $16.98 | $16.98 | $19.50 |
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 $8.51 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $8.51 | $8.51 | $8.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $3.39 | $3.39 | $3.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $1.70 |
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· 45th of 51
$17.38
AK $21.88NC $16.98
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.