How much rates vary
Facilitymedian $1,413 · 10th to 90th $977 to $8,128Professionalmedian $1,288 · 10th to 90th $724 to $1,950
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 $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | None | $912.01 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $3,162.28 Typical High $4,168.69 | Facility | None | $1,412.54 | $3,162.28 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $1,995.26 | Professional | None | $758.58 | $1,174.90 | $1,995.26 |
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 $1,096.48 Median $1,949.84 Typical High $24,547.09 | Facility | None | $1,096.48 | $1,949.84 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,096.48 | $1,698.24 |
Pacific Source Setting Facility Modifier None Typical Low $831.76 Median $1,348.96 Typical High $1,445.44 | Facility | None | $831.76 | $1,348.96 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $1,258.93 Median $2,818.38 Typical High $4,168.69 | Facility | None | $1,258.93 | $2,818.38 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,288.25 Typical High $1,995.26 | Professional | None | $79.43 | $1,288.25 | $1,995.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $11,481.54 Typical High $12,882.50 | Facility | None | $8,128.31 | $11,481.54 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,445.44 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,288.25 Typical High $2,089.30 | Professional | None | $831.76 | $1,288.25 | $2,089.30 |
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 $407.38 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $16,982.44 Typical High $19,498.45 | Facility | 50 · Both sides | $12,302.69 | $16,982.44 | $19,498.45 |
Where Oregon sits
The same service costs 8.7 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· 10th of 51
$1,349
AK $2,951TX $339
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.