How much rates vary
Facilitymedian $1,318 · 10th to 90th $794 to $5,248Professionalmedian $1,072 · 10th to 90th $575 to $1,778
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 $977.24 Median $8,317.64 Typical High $17,378.01 | Facility | None | $977.24 | $8,317.64 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,202.26 | Professional | None | $524.81 | $794.33 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $2,884.03 | Facility | None | $1,000.00 | $2,187.76 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,949.84 | Professional | None | $831.76 | $1,096.48 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,737.80 | Professional | None | $933.25 | $1,202.26 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $1,584.89 Typical High $13,182.57 | Facility | None | $977.24 | $1,584.89 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $912.01 Typical High $1,412.54 | Professional | None | $549.54 | $912.01 | $1,412.54 |
Pacific Source Setting Facility Modifier None Typical Low $794.33 Median $1,318.26 Typical High $1,412.54 | Facility | None | $794.33 | $1,318.26 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $1,862.09 Typical High $2,884.03 | Facility | None | $891.25 | $1,862.09 | $2,884.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,122.02 Typical High $1,862.09 | Professional | None | $79.43 | $1,122.02 | $1,862.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $7,413.10 | Facility | None | $4,786.30 | $6,456.54 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,348.96 | $1,698.24 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,995.26 | Professional | None | $812.83 | $1,202.26 | $1,995.26 |
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 $281.84 Median $389.05 Typical High $501.19 | Professional | 52 · Reduced service | $281.84 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $158.49 Typical High $199.53 | Professional | 53 · Discontinued | $112.20 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $588.84 Typical High $741.31 | Professional | 54 · Surgery only | $426.58 | $588.84 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $117.49 Typical High $147.91 | Professional | 55 · Aftercare only | $85.11 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $79.43 Typical High $100.00 | Professional | 56 · Pre-op care only | $56.23 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $549.54 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $398.11 | $549.54 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $389.05 Typical High $501.19 | Professional | 52 · Reduced service | $281.84 | $389.05 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $158.49 Typical High $199.53 | Professional | 53 · Discontinued | $112.20 | $158.49 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $588.84 Typical High $741.31 | Professional | 54 · Surgery only | $426.58 | $588.84 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $117.49 Typical High $147.91 | Professional | 55 · Aftercare only | $85.11 | $117.49 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $79.43 Typical High $100.00 | Professional | 56 · Pre-op care only | $56.23 | $79.43 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $549.54 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $398.11 | $549.54 | $691.83 |
Where Oregon sits
The same service costs 4.3 times more in Alaska than in Texas. 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· 7th of 51
$1,175
AK $2,291TX $537
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.