How much rates vary
Facilitymedian $54 · 10th to 90th $36 to $81Professionalmedian $36 · 10th to 90th $36 to $50
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 $36.31 Median $36.31 Typical High $37.15 | Professional | None | $36.31 | $36.31 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $61.66 Typical High $77.62 | Facility | None | $37.15 | $61.66 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $39.81 | Professional | None | $36.31 | $36.31 | $39.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $104.71 | Professional | None | $41.69 | $79.43 | $104.71 |
Moda Health Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $61.66 | Facility | None | $36.31 | $36.31 | $61.66 |
Moda Health Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $42.66 | Professional | None | $36.31 | $36.31 | $42.66 |
Pacific Source Setting Facility Modifier None Typical Low $36.31 Median $45.71 Typical High $75.86 | Facility | None | $36.31 | $45.71 | $75.86 |
Providence Setting Facility Modifier None Typical Low $38.02 Median $44.67 Typical High $75.86 | Facility | None | $38.02 | $44.67 | $75.86 |
Providence Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $70.79 | Professional | None | $36.31 | $45.71 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $46.77 Median $63.10 Typical High $123.03 | Facility | None | $46.77 | $63.10 | $123.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | None | $33.11 | $36.31 | $36.31 |
United Setting Facility Modifier None Typical Low $36.31 Median $74.13 Typical High $87.10 | Facility | None | $36.31 | $74.13 | $87.10 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | None | $36.31 | $36.31 | $41.69 |
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 $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.41 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
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· 31st of 51
$36.31
AK $50.12GA $36.31
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.