How much rates vary
Facilitymedian $490 · 10th to 90th $288 to $4,169Professionalmedian $457 · 10th to 90th $275 to $692
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | None | $309.03 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $2,238.72 | Facility | None | $660.69 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $707.95 | Professional | None | $269.15 | $426.58 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $691.83 | Professional | None | $489.78 | $588.84 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $562.34 Typical High $6,606.93 | Facility | None | $371.54 | $562.34 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $588.84 | Professional | None | $346.74 | $354.81 | $588.84 |
Pacific Source Setting Facility Modifier None Typical Low $275.42 Median $436.52 Typical High $501.19 | Facility | None | $275.42 | $436.52 | $501.19 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $1,318.26 Typical High $2,238.72 | Facility | None | $446.68 | $1,318.26 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $457.09 Typical High $707.95 | Professional | None | $79.43 | $457.09 | $707.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,309.57 | Facility | None | $4,073.80 | $5,623.41 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $645.65 | Professional | None | $478.63 | $501.19 | $645.65 |
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 $269.15 Median $426.58 Typical High $724.44 | Professional | None | $269.15 | $426.58 | $724.44 |
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 $141.25 Median $169.82 Typical High $173.78 | Professional | 52 · Reduced service | $141.25 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $56.23 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $257.04 Typical High $263.03 | Professional | 54 · Surgery only | $208.93 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $51.29 Typical High $52.48 | Professional | 55 · Aftercare only | $41.69 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $239.88 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $194.98 | $239.88 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 52 · Reduced service | $169.82 | $169.82 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $69.18 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | 54 · Surgery only | $257.04 | $257.04 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $52.48 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $245.47 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,025.60 Median $8,317.64 Typical High $9,549.93 | Facility | 50 · Both sides | $6,025.60 | $8,317.64 | $9,549.93 |
Where Oregon sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 9th of 51
$457
AK $1,023UT $191
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.