How much rates vary
Facilitymedian $52 · 10th to 90th $42 to $93Professionalmedian $44 · 10th to 90th $43 to $60
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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $54.95 | Professional | None | $43.65 | $43.65 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $69.18 Typical High $93.33 | Facility | None | $42.66 | $69.18 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $47.86 | Professional | None | $43.65 | $43.65 | $47.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $91.20 Typical High $120.23 | Professional | None | $50.12 | $91.20 | $120.23 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $46.77 Typical High $281.84 | Facility | None | $43.65 | $46.77 | $281.84 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $54.95 | Professional | None | $42.66 | $43.65 | $54.95 |
Pacific Source Setting Facility Modifier None Typical Low $41.69 Median $48.98 Typical High $87.10 | Facility | None | $41.69 | $48.98 | $87.10 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $50.12 Typical High $81.28 | Facility | None | $43.65 | $50.12 | $81.28 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $79.43 | Professional | None | $43.65 | $51.29 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $41.69 Median $57.54 Typical High $123.03 | Facility | None | $41.69 | $57.54 | $123.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $43.65 | Professional | None | $39.81 | $43.65 | $43.65 |
United Setting Facility Modifier None Typical Low $43.65 Median $89.13 Typical High $104.71 | Facility | None | $43.65 | $89.13 | $104.71 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | None | $42.66 | $42.66 | $48.98 |
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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $20.89 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
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· 51st of 51
$43.65
AK $54.95OR $43.65
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.