How much rates vary
Facilitymedian $759 · 10th to 90th $501 to $4,074Professionalmedian $562 · 10th to 90th $309 to $955
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 $3,890.45 Median $5,623.41 Typical High $8,709.64 | Facility | None | $3,890.45 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $562.34 | Professional | None | $245.47 | $389.05 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,412.54 Typical High $1,905.46 | Facility | None | $812.83 | $1,412.54 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $1,047.13 | Professional | None | $407.38 | $575.44 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $954.99 | Professional | None | $436.52 | $588.84 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $812.83 Typical High $7,943.28 | Facility | None | $549.54 | $812.83 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $467.74 Typical High $758.58 | Professional | None | $257.04 | $467.74 | $758.58 |
Pacific Source Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $794.33 | Facility | None | $446.68 | $741.31 | $794.33 |
Providence Setting Facility Modifier None Typical Low $588.84 Median $1,122.02 Typical High $1,905.46 | Facility | None | $588.84 | $1,122.02 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $575.44 Typical High $977.24 | Professional | None | $79.43 | $575.44 | $977.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $831.76 | Professional | None | $537.03 | $724.44 | $831.76 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,244.36 | Facility | None | $602.56 | $1,000.00 | $7,244.36 |
United Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $1,047.13 | Professional | None | $416.87 | $676.08 | $1,047.13 |
12 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 $158.49 Median $194.98 Typical High $275.42 | Professional | 52 · Reduced service | $158.49 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $77.62 Typical High $112.20 | Professional | 53 · Discontinued | $63.10 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $295.12 Typical High $416.87 | Professional | 54 · Surgery only | $239.88 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $58.88 Typical High $83.18 | Professional | 55 · Aftercare only | $47.86 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $38.90 Typical High $56.23 | Professional | 56 · Pre-op care only | $31.62 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $275.42 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $223.87 | $275.42 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $194.98 Typical High $275.42 | Professional | 52 · Reduced service | $158.49 | $194.98 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $77.62 Typical High $112.20 | Professional | 53 · Discontinued | $63.10 | $77.62 | $112.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $295.12 Typical High $416.87 | Professional | 54 · Surgery only | $239.88 | $295.12 | $416.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $58.88 Typical High $83.18 | Professional | 55 · Aftercare only | $47.86 | $58.88 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $38.90 Typical High $56.23 | Professional | 56 · Pre-op care only | $31.62 | $38.90 | $56.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $275.42 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $223.87 | $275.42 | $389.05 |
Where Oregon sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 4th of 51
$646
AK $1,259UT $324
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.