How much rates vary
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 $32.36 Median $32.36 Typical High $33.11 | Professional | None | $32.36 | $32.36 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $45.71 Typical High $69.18 | Facility | None | $42.66 | $45.71 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $35.48 | Professional | None | $32.36 | $32.36 | $35.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $70.79 Typical High $91.20 | Professional | None | $37.15 | $70.79 | $91.20 |
Moda Health Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $41.69 | Facility | None | $32.36 | $32.36 | $41.69 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | None | $32.36 | $32.36 | $37.15 |
Pacific Source Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $66.07 | Facility | None | $32.36 | $32.36 | $66.07 |
Providence Setting Facility Modifier None Typical Low $35.48 Median $39.81 Typical High $64.57 | Facility | None | $35.48 | $39.81 | $64.57 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $70.79 | Professional | None | $32.36 | $40.74 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $32.36 Median $44.67 Typical High $77.62 | Facility | None | $32.36 | $44.67 | $77.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.20 Median $32.36 Typical High $32.36 | Professional | None | $30.20 | $32.36 | $32.36 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | None | $32.36 | $32.36 | $37.15 |
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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
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· 41st of 51
$32.36
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.