How much rates vary
Facilitymedian $724 · 10th to 90th $603 to $1,413Professionalmedian $692 · 10th to 90th $646 to $813
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 $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,445.44 | Facility | None | $691.83 | $1,096.48 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $741.31 | Professional | None | $691.83 | $691.83 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $1,479.11 Typical High $1,737.80 | Professional | None | $691.83 | $1,479.11 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $977.24 | Facility | None | $691.83 | $691.83 | $977.24 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $794.33 | Professional | None | $691.83 | $691.83 | $794.33 |
Pacific Source Setting Facility Modifier None Typical Low $602.56 Median $691.83 Typical High $1,288.25 | Facility | None | $602.56 | $691.83 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,445.44 | Facility | None | $691.83 | $1,023.29 | $1,445.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $691.83 Typical High $870.96 | Professional | None | $79.43 | $691.83 | $870.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $870.96 Typical High $1,862.09 | Facility | None | $676.08 | $870.96 | $1,862.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $691.83 | Professional | None | $645.65 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,412.54 Typical High $1,659.59 | Facility | None | $691.83 | $1,412.54 | $1,659.59 |
United Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $794.33 | Professional | None | $691.83 | $691.83 | $794.33 |
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 $338.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
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· 40th of 51
$692
AK $832IN $692
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.