How much rates vary
Facilitymedian $40 · 10th to 90th $30 to $63Professionalmedian $33 · 10th to 90th $31 to $44
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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | None | $33.11 | $33.11 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $50.12 Typical High $69.18 | Facility | None | $31.62 | $50.12 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $35.48 | Professional | None | $33.11 | $33.11 | $35.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $67.61 Typical High $85.11 | Professional | None | $38.02 | $67.61 | $85.11 |
Moda Health Setting Facility Modifier None Typical Low $33.11 Median $34.67 Typical High $44.67 | Facility | None | $33.11 | $34.67 | $44.67 |
Moda Health Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $40.74 | Professional | None | $30.90 | $33.11 | $40.74 |
Pacific Source Setting Facility Modifier None Typical Low $30.20 Median $37.15 Typical High $61.66 | Facility | None | $30.20 | $37.15 | $61.66 |
Providence Setting Facility Modifier None Typical Low $30.90 Median $34.67 Typical High $57.54 | Facility | None | $30.90 | $34.67 | $57.54 |
Providence Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $70.79 | Professional | None | $33.11 | $36.31 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $30.20 Median $39.81 Typical High $85.11 | Facility | None | $30.20 | $39.81 | $85.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $33.11 | Professional | None | $30.20 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $33.11 Median $67.61 Typical High $79.43 | Facility | None | $33.11 | $67.61 | $79.43 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $36.31 | Professional | None | $30.90 | $30.90 | $36.31 |
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 $16.60 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
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 $3.31 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.16 |
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· 13th of 51
$33.11
AK $41.69AZ $33.11
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.