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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | None | $933.25 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $12,589.25 Typical High $17,378.01 | Facility | None | $870.96 | $12,589.25 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $2,041.74 | Professional | None | $776.25 | $1,230.27 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,513.56 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $7,943.28 | Facility | None | $1,071.52 | $1,737.80 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,122.02 | $1,621.81 |
Pacific Source Setting Facility Modifier None Typical Low $851.14 Median $1,380.38 Typical High $1,479.11 | Facility | None | $851.14 | $1,380.38 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $11,481.54 Typical High $16,218.10 | Facility | None | $1,000.00 | $11,481.54 | $16,218.10 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,318.26 Typical High $2,041.74 | Professional | None | $79.43 | $1,318.26 | $2,041.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $13,489.63 Median $41,686.94 Typical High $57,543.99 | Facility | None | $13,489.63 | $41,686.94 | $57,543.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,479.11 | $1,949.84 |
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 $831.76 Median $1,318.26 Typical High $2,187.76 | Professional | None | $831.76 | $1,318.26 | $2,187.76 |
12 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 $416.87 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $416.87 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $169.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
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· 10th of 51
$1,380
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.