How much rates vary
Facilitymedian $186 · 10th to 90th $138 to $331Professionalmedian $145 · 10th to 90th $138 to $178
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 $144.54 Median $331.13 Typical High $331.13 | Facility | None | $144.54 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $165.96 | Professional | None | $144.54 | $144.54 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $302.00 | Facility | None | $138.04 | $223.87 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $154.88 | Professional | None | $144.54 | $144.54 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $354.81 | Professional | None | $165.96 | $295.12 | $354.81 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $331.13 | Facility | None | $144.54 | $151.36 | $331.13 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $173.78 | Professional | None | $138.04 | $144.54 | $173.78 |
Pacific Source Setting Facility Modifier None Typical Low $138.04 Median $169.82 Typical High $281.84 | Facility | None | $138.04 | $169.82 | $281.84 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $218.78 Typical High $302.00 | Facility | None | $144.54 | $218.78 | $302.00 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $181.97 | Professional | None | $79.43 | $144.54 | $181.97 |
Regence BlueShield Setting Facility Modifier None Typical Low $134.90 Median $181.97 Typical High $389.05 | Facility | None | $134.90 | $181.97 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | None | $131.83 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $144.54 Median $295.12 Typical High $346.74 | Facility | None | $144.54 | $295.12 | $346.74 |
United Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | None | $138.04 | $138.04 | $158.49 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
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· 29th of 51
$145
AK $178TN $145
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.