How much rates vary
Facilitymedian $1,413 · 10th to 90th $955 to $9,120Professionalmedian $1,318 · 10th to 90th $692 to $1,905
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 $870.96 Median $954.99 Typical High $954.99 | Professional | None | $870.96 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $6,918.31 Typical High $9,549.93 | Facility | None | $870.96 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,905.46 | Professional | None | $724.44 | $1,122.02 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,445.44 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $1,258.93 Median $2,290.87 Typical High $24,547.09 | Facility | None | $1,258.93 | $2,290.87 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,737.80 | Professional | None | $954.99 | $1,202.26 | $1,737.80 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,348.96 Typical High $1,479.11 | Facility | None | $891.25 | $1,348.96 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $954.99 Median $6,165.95 Typical High $8,912.51 | Facility | None | $954.99 | $6,165.95 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,318.26 Typical High $1,949.84 | Professional | None | $79.43 | $1,318.26 | $1,949.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $21,379.62 Typical High $29,512.09 | Facility | None | $6,918.31 | $21,379.62 | $29,512.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,445.44 | $1,862.09 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $2,137.96 | Professional | None | $954.99 | $1,318.26 | $2,137.96 |
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 $407.38 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $407.38 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $162.18 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $81.28 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
Where Oregon sits
The same service costs 7.2 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· 11th of 51
$1,349
AK $2,884TX $398
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.