How much rates vary
Facilitymedian $1,995 · 10th to 90th $1,175 to $20,893Professionalmedian $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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,288.25 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $16,982.44 Typical High $23,442.29 | Facility | None | $1,000.00 | $16,982.44 | $23,442.29 |
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 $1,778.28 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,778.28 | $2,041.74 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $17,378.01 | Facility | None | $1,584.89 | $2,754.23 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,584.89 | $2,398.83 |
Pacific Source Setting Facility Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $2,041.74 | Facility | None | $1,174.90 | $1,949.84 | $2,041.74 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $15,488.17 Typical High $21,877.62 | Facility | None | $1,047.13 | $15,488.17 | $21,877.62 |
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 $33,884.42 Median $44,668.36 Typical High $56,234.13 | Facility | None | $33,884.42 | $44,668.36 | $56,234.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,041.74 | $2,691.53 |
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 $1,230.27 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,230.27 | $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 $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $575.44 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $281.84 | $281.84 |
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 $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $141.25 | $141.25 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
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 $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
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 $51,286.14 Median $67,608.30 Typical High $85,113.80 | Facility | 50 · Both sides | $51,286.14 | $67,608.30 | $85,113.80 |
Where Oregon sits
The same service costs 7.2 times more in Alaska than in Hawaii. 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.
Physician feeFacility fee
AK $19,657HI $2,734
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.