How much rates vary
Facilitymedian $1,148 · 10th to 90th $776 to $12,023Professionalmedian $1,047 · 10th to 90th $575 to $1,585
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 $1,000.00 Median $8,317.64 Typical High $17,378.01 | Facility | None | $1,000.00 | $8,317.64 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $812.83 Typical High $812.83 | Professional | None | $512.86 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $8,709.64 Typical High $12,022.64 | Facility | None | $1,000.00 | $8,709.64 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $977.24 Typical High $1,621.81 | Professional | None | $616.60 | $977.24 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,202.26 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $1,548.82 Typical High $17,378.01 | Facility | None | $977.24 | $1,548.82 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,380.38 | Professional | None | $812.83 | $912.01 | $1,380.38 |
Pacific Source Setting Facility Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,174.90 | Facility | None | $660.69 | $1,071.52 | $1,174.90 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $7,943.28 Typical High $12,022.64 | Facility | None | $891.25 | $7,943.28 | $12,022.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,047.13 Typical High $1,621.81 | Professional | None | $79.43 | $1,047.13 | $1,621.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,782.79 Median $25,118.86 Typical High $28,183.83 | Facility | None | $17,782.79 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,174.90 | $1,548.82 |
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 $660.69 Median $1,047.13 Typical High $1,698.24 | Professional | None | $660.69 | $1,047.13 | $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 $501.19 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $501.19 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $100.00 | $123.03 | $123.03 |
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 $467.74 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $467.74 | $575.44 | $575.44 |
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 $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
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 $575.44 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $575.44 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $26,915.35 Median $37,153.52 Typical High $42,657.95 | Facility | 50 · Both sides | $26,915.35 | $37,153.52 | $42,657.95 |
Where Oregon sits
The same service costs 7.8 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
$1,096
AK $2,399TX $309
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.