How much rates vary
Facilitymedian $1,479 · 10th to 90th $933 to $10,233Professionalmedian $1,349 · 10th to 90th $759 to $2,042
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 $1,348.96 Median $12,302.69 Typical High $33,884.42 | Facility | None | $1,348.96 | $12,302.69 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | None | $977.24 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,949.84 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $2,089.30 | Professional | None | $794.33 | $1,258.93 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,548.82 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $33,884.42 | Facility | None | $1,202.26 | $1,584.89 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,096.48 | $1,737.80 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,513.56 | Facility | None | $891.25 | $1,288.25 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $1,479.11 Median $5,128.61 Typical High $7,762.47 | Facility | None | $1,479.11 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,318.26 Typical High $2,089.30 | Professional | None | $79.43 | $1,318.26 | $2,089.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $20,417.38 Typical High $23,442.29 | Facility | None | $14,454.40 | $20,417.38 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,513.56 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $2,238.72 | Professional | None | $870.96 | $1,348.96 | $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 $426.58 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $426.58 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $169.82 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $645.65 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $85.11 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $602.56 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $218.78 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Where Oregon sits
The same service costs 17.4 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
$1,413
AK $3,020TX $174
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.