How much rates vary
Facilitymedian $38 · 10th to 90th $35 to $74Professionalmedian $38 · 10th to 90th $37 to $49
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 $46.77 Median $46.77 Typical High $56.23 | Facility | None | $46.77 | $46.77 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $41.69 | Professional | None | $38.02 | $38.02 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $60.26 Typical High $79.43 | Facility | None | $37.15 | $60.26 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $40.74 | Professional | None | $38.02 | $38.02 | $40.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $102.33 | Professional | None | $43.65 | $79.43 | $102.33 |
Moda Health Setting Facility Modifier None Typical Low $38.02 Median $39.81 Typical High $52.48 | Facility | None | $38.02 | $39.81 | $52.48 |
Moda Health Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $45.71 | Professional | None | $37.15 | $38.02 | $45.71 |
Pacific Source Setting Facility Modifier None Typical Low $34.67 Median $36.31 Typical High $61.66 | Facility | None | $34.67 | $36.31 | $61.66 |
Providence Setting Facility Modifier None Typical Low $38.02 Median $42.66 Typical High $70.79 | Facility | None | $38.02 | $42.66 | $70.79 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $44.67 Typical High $70.79 | Professional | None | $38.02 | $44.67 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $36.31 Median $50.12 Typical High $107.15 | Facility | None | $36.31 | $50.12 | $107.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $38.02 | Professional | None | $35.48 | $38.02 | $38.02 |
United Setting Facility Modifier None Typical Low $38.02 Median $77.62 Typical High $91.20 | Facility | None | $38.02 | $77.62 | $91.20 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $42.66 | Professional | None | $37.15 | $37.15 | $42.66 |
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 $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
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 $7.41 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.41 |
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 $3.72 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.72 |
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· 32nd of 51
$38.02
AK $47.86HI $37.15
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.