How much rates vary
Facilitymedian $1,318 · 10th to 90th $776 to $3,981Professionalmedian $1,175 · 10th to 90th $776 to $1,820
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,047.13 | Professional | None | $794.33 | $870.96 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,258.93 Typical High $1,698.24 | Facility | None | $724.44 | $1,258.93 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,949.84 | Professional | None | $776.25 | $1,096.48 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,445.44 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $8,709.64 | Facility | None | $1,047.13 | $1,513.56 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,548.82 | Professional | None | $870.96 | $1,047.13 | $1,548.82 |
Pacific Source Setting Facility Modifier None Typical Low $794.33 Median $1,318.26 Typical High $1,412.54 | Facility | None | $794.33 | $1,318.26 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $1,318.26 Typical High $1,819.70 | Facility | None | $870.96 | $1,318.26 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,174.90 Typical High $1,819.70 | Professional | None | $79.43 | $1,174.90 | $1,819.70 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $6,025.60 | Facility | None | $3,801.89 | $5,248.07 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,348.96 | $1,659.59 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,905.46 | Professional | None | $776.25 | $1,148.15 | $1,905.46 |
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 $398.11 Median $436.52 Typical High $524.81 | Professional | 52 · Reduced service | $398.11 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $213.80 | Professional | 53 · Discontinued | $162.18 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $794.33 | Professional | 54 · Surgery only | $602.56 | $660.69 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $158.49 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $104.71 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | 52 · Reduced service | $436.52 | $436.52 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $213.80 | Professional | 53 · Discontinued | $173.78 | $173.78 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $794.33 | Professional | 54 · Surgery only | $660.69 | $660.69 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $741.31 |
Where Oregon sits
The same service costs 5.6 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
$1,175
AK $2,399TX $427
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.