How much rates vary
Facilitymedian $513 · 10th to 90th $263 to $776Professionalmedian $501 · 10th to 90th $295 to $759
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 $257.04 Median $371.54 Typical High $389.05 | Professional | None | $257.04 | $371.54 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $281.84 Typical High $660.69 | Facility | None | $223.87 | $281.84 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $776.25 | Professional | None | $302.00 | $467.74 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $794.33 | Professional | None | $537.03 | $660.69 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $645.65 Typical High $6,606.93 | Facility | None | $426.58 | $645.65 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $645.65 | Professional | None | $288.40 | $398.11 | $645.65 |
Pacific Source Setting Facility Modifier None Typical Low $309.03 Median $512.86 Typical High $562.34 | Facility | None | $309.03 | $512.86 | $562.34 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $407.38 Typical High $741.31 | Facility | None | $229.09 | $407.38 | $741.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $512.86 Typical High $794.33 | Professional | None | $79.43 | $512.86 | $794.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $954.99 | Facility | None | $645.65 | $812.83 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $707.95 | Professional | None | $524.81 | $549.54 | $707.95 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $831.76 | Professional | None | $309.03 | $478.63 | $831.76 |
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 $158.49 Median $186.21 Typical High $194.98 | Professional | 52 · Reduced service | $158.49 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $74.13 Typical High $77.62 | Professional | 53 · Discontinued | $63.10 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $234.42 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $47.86 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $37.15 Typical High $38.90 | Professional | 56 · Pre-op care only | $31.62 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $263.03 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $218.78 | $263.03 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $194.98 | Professional | 52 · Reduced service | $186.21 | $186.21 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $77.62 | Professional | 53 · Discontinued | $74.13 | $74.13 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $281.84 | $281.84 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $38.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $275.42 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Facility | 50 · Both sides | $954.99 | $1,230.27 | $1,445.44 |
Where Oregon sits
The same service costs 5.9 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· 9th of 51
$501
AK $1,096TX $186
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.