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 $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 $741.31 Median $812.83 Typical High $812.83 | Professional | None | $741.31 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $4,073.80 Typical High $5,495.41 | Facility | None | $891.25 | $4,073.80 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,621.81 | Professional | None | $616.60 | $954.99 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,202.26 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,548.82 Typical High $8,709.64 | Facility | None | $891.25 | $1,548.82 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,380.38 | Professional | None | $812.83 | $891.25 | $1,380.38 |
Pacific Source Setting Facility Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,148.15 | Facility | None | $660.69 | $1,071.52 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $3,630.78 Typical High $5,495.41 | Facility | None | $870.96 | $3,630.78 | $5,495.41 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,047.13 Typical High $1,584.89 | Professional | None | $79.43 | $1,047.13 | $1,584.89 |
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 $1,122.02 Median $1,174.90 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,174.90 | $1,513.56 |
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 $645.65 Median $1,023.29 Typical High $1,698.24 | Professional | None | $645.65 | $1,023.29 | $1,698.24 |
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 $331.13 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
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 8.3 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
$1,072
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.