How much rates vary
Facilitymedian $32 · 10th to 90th $22 to $81Professionalmedian $26 · 10th to 90th $25 to $34
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 $38.90 Median $38.90 Typical High $104.71 | Facility | None | $38.90 | $38.90 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $32.36 | Professional | None | $25.70 | $25.70 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $32.36 Typical High $53.70 | Facility | None | $25.70 | $32.36 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.70 Typical High $25.70 | Professional | None | $25.12 | $25.70 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $56.23 Typical High $72.44 | Professional | None | $42.66 | $56.23 | $72.44 |
Moda Health Setting Facility Modifier None Typical Low $25.70 Median $27.54 Typical High $97.72 | Facility | None | $25.70 | $27.54 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $32.36 | Professional | None | $25.70 | $25.70 | $32.36 |
Pacific Source Setting Facility Modifier None Typical Low $25.12 Median $32.36 Typical High $52.48 | Facility | None | $25.12 | $32.36 | $52.48 |
Providence Setting Facility Modifier None Typical Low $19.95 Median $25.70 Typical High $53.70 | Facility | None | $19.95 | $25.70 | $53.70 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $70.79 | Professional | None | $25.70 | $28.18 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $33.88 Median $63.10 Typical High $95.50 | Facility | None | $33.88 | $63.10 | $95.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $24.55 Median $25.70 Typical High $25.70 | Professional | None | $24.55 | $25.70 | $25.70 |
United Setting Facility Modifier None Typical Low $25.70 Median $52.48 Typical High $61.66 | Facility | None | $25.70 | $52.48 | $61.66 |
United Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $29.51 | Professional | None | $25.70 | $25.70 | $29.51 |
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 $12.88 Median $12.88 Typical High $13.18 | Professional | 52 · Reduced service | $12.88 | $12.88 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.25 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.88 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $3.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.57 |
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· 30th of 51
$25.70
WY $36.31NC $25.12
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.