How much rates vary
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 $13,489.63 Typical High $33,884.42 | Facility | None | $5,128.61 | $13,489.63 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $776.25 | $1,047.13 | $1,047.13 |
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 $776.25 Median $1,230.27 Typical High $2,041.74 | Professional | None | $776.25 | $1,230.27 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,479.11 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $33,884.42 | Facility | None | $1,148.15 | $1,995.26 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,096.48 | $1,659.59 |
Pacific Source Setting Facility Modifier None Typical Low $870.96 Median $1,380.38 Typical High $1,479.11 | Facility | None | $870.96 | $1,380.38 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $1,412.54 Median $5,128.61 Typical High $8,317.64 | Facility | None | $1,412.54 | $5,128.61 | $8,317.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,318.26 Typical High $2,041.74 | Professional | None | $79.43 | $1,318.26 | $2,041.74 |
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 $1,412.54 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,479.11 | $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 $851.14 Median $1,318.26 Typical High $2,187.76 | Professional | None | $851.14 | $1,318.26 | $2,187.76 |
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 $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $426.58 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $169.82 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $208.93 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
Where Oregon sits
The same service costs 8.5 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
$1,413
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.