How much rates vary
Facilitymedian $1,175 · 10th to 90th $813 to $5,129Professionalmedian $1,122 · 10th to 90th $617 to $1,660
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 $616.60 Median $851.14 Typical High $851.14 | Professional | None | $616.60 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,659.59 Typical High $2,238.72 | Facility | None | $954.99 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,698.24 | Professional | None | $630.96 | $1,000.00 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,258.93 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $17,378.01 | Facility | None | $1,096.48 | $1,659.59 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,445.44 | Professional | None | $851.14 | $933.25 | $1,445.44 |
Pacific Source Setting Facility Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,230.27 | Facility | None | $691.83 | $1,122.02 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,398.83 | Facility | None | $954.99 | $1,584.89 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,122.02 Typical High $1,659.59 | Professional | None | $79.43 | $1,122.02 | $1,659.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,230.27 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,778.28 | Professional | None | $794.33 | $1,071.52 | $1,778.28 |
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 $338.84 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $338.84 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $138.04 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $512.86 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $102.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $478.63 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
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 7.4 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
$1,148
AK $2,455TX $331
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.