How much rates vary
Facilitymedian $1,549 · 10th to 90th $891 to $5,129Professionalmedian $1,230 · 10th to 90th $676 to $1,995
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 $5,128.61 Median $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $912.01 Typical High $1,202.26 | Professional | None | $575.44 | $912.01 | $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 $933.25 Median $1,230.27 Typical High $2,187.76 | Professional | None | $933.25 | $1,230.27 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,348.96 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $13,182.57 | Facility | None | $1,000.00 | $1,862.09 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,513.56 | Professional | None | $645.65 | $1,023.29 | $1,513.56 |
Pacific Source Setting Facility Modifier None Typical Low $912.01 Median $1,513.56 Typical High $1,584.89 | Facility | None | $912.01 | $1,513.56 | $1,584.89 |
Providence Setting Facility Modifier None Typical Low $954.99 Median $1,949.84 Typical High $2,884.03 | Facility | None | $954.99 | $1,949.84 | $2,884.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,288.25 Typical High $2,089.30 | Professional | None | $79.43 | $1,288.25 | $2,089.30 |
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 $1,230.27 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,513.56 | $1,905.46 |
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 $933.25 Median $1,380.38 Typical High $2,238.72 | Professional | None | $933.25 | $1,380.38 | $2,238.72 |
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 $323.59 Median $457.09 Typical High $562.34 | Professional | 52 · Reduced service | $323.59 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $181.97 Typical High $223.87 | Professional | 53 · Discontinued | $131.83 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $691.83 Typical High $851.14 | Professional | 54 · Surgery only | $489.78 | $691.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $138.04 Typical High $169.82 | Professional | 55 · Aftercare only | $97.72 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $91.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $64.57 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $645.65 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $457.09 | $645.65 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $457.09 Typical High $562.34 | Professional | 52 · Reduced service | $323.59 | $457.09 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $181.97 Typical High $223.87 | Professional | 53 · Discontinued | $131.83 | $181.97 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $691.83 Typical High $851.14 | Professional | 54 · Surgery only | $489.78 | $691.83 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $138.04 Typical High $169.82 | Professional | 55 · Aftercare only | $97.72 | $138.04 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $91.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $64.57 | $91.20 | $112.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $645.65 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $457.09 | $645.65 | $794.33 |
Where Oregon sits
The same service costs 4.5 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· 8th of 51
$1,318
AK $2,630TX $589
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.