How much rates vary
Facilitymedian $776 · 10th to 90th $363 to $1,047Professionalmedian $724 · 10th to 90th $479 to $1,175
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $660.69 | Professional | None | $398.11 | $501.19 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $457.09 Typical High $676.08 | Facility | None | $363.08 | $457.09 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $1,230.27 | Professional | None | $524.81 | $707.95 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,071.52 | Professional | None | $562.34 | $741.31 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $933.25 Typical High $7,943.28 | Facility | None | $562.34 | $933.25 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $933.25 | Professional | None | $501.19 | $660.69 | $933.25 |
Pacific Source Setting Facility Modifier None Typical Low $524.81 Median $851.14 Typical High $912.01 | Facility | None | $524.81 | $851.14 | $912.01 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $549.54 Typical High $1,148.15 | Facility | None | $380.19 | $549.54 | $1,148.15 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $741.31 Typical High $1,174.90 | Professional | None | $79.43 | $741.31 | $1,174.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,621.81 | Facility | None | $954.99 | $1,348.96 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,071.52 | Professional | None | $676.08 | $831.76 | $1,071.52 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,258.93 | Professional | None | $524.81 | $794.33 | $1,258.93 |
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 $199.53 Median $251.19 Typical High $331.13 | Professional | 52 · Reduced service | $199.53 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $100.00 Typical High $131.83 | Professional | 53 · Discontinued | $79.43 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $371.54 Typical High $489.78 | Professional | 54 · Surgery only | $302.00 | $371.54 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $97.72 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $50.12 Typical High $66.07 | Professional | 56 · Pre-op care only | $39.81 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $346.74 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $281.84 | $346.74 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $251.19 Typical High $331.13 | Professional | 52 · Reduced service | $199.53 | $251.19 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $100.00 Typical High $131.83 | Professional | 53 · Discontinued | $79.43 | $100.00 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $371.54 Typical High $489.78 | Professional | 54 · Surgery only | $302.00 | $371.54 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $97.72 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $50.12 Typical High $66.07 | Professional | 56 · Pre-op care only | $39.81 | $50.12 | $66.07 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $346.74 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $281.84 | $346.74 | $457.09 |
Where Oregon sits
The same service costs 6.0 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
$741
AK $1,445TX $240
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.