How much rates vary
Facilitymedian $1,995 · 10th to 90th $1,202 to $9,772Professionalmedian $1,862 · 10th to 90th $1,023 to $2,754
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,318.26 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,412.54 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,698.24 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,737.80 | $2,041.74 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $2,754.23 Typical High $24,547.09 | Facility | None | $1,513.56 | $2,754.23 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,513.56 | $2,344.23 |
Pacific Source Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $2,041.74 | Facility | None | $1,174.90 | $1,905.46 | $2,041.74 |
Providence Setting Facility Modifier None Typical Low $1,412.54 Median $5,128.61 Typical High $7,762.47 | Facility | None | $1,412.54 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,862.09 Typical High $2,818.38 | Professional | None | $79.43 | $1,862.09 | $2,818.38 |
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 $1,905.46 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,041.74 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,819.70 | $3,019.95 |
13 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 $575.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $575.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $173.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $114.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $288.40 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,000.00 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $21,877.62 Median $30,199.52 Typical High $34,673.69 | Facility | 50 · Both sides | $21,877.62 | $30,199.52 | $34,673.69 |
Where Oregon sits
The same service costs 21.4 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· 9th of 51
$1,905
AK $4,074TX $191
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.