How much rates vary
Facilitymedian $1,514 · 10th to 90th $1,023 to $8,128Professionalmedian $1,445 · 10th to 90th $776 to $2,089
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 $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | None | $977.24 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $4,168.69 | Facility | None | $1,000.00 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $2,137.96 | Professional | None | $812.83 | $1,288.25 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,584.89 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $17,378.01 | Facility | None | $1,148.15 | $2,089.30 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,230.27 | $1,819.70 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,445.44 Typical High $1,548.82 | Facility | None | $891.25 | $1,445.44 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $2,754.23 Typical High $4,168.69 | Facility | None | $1,047.13 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,412.54 Typical High $2,137.96 | Professional | None | $79.43 | $1,412.54 | $2,137.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $11,481.54 Typical High $12,882.50 | Facility | None | $8,128.31 | $11,481.54 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,479.11 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,548.82 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,380.38 | $2,290.87 |
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 $436.52 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $436.52 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $660.69 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $87.10 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $616.60 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $16,982.44 Typical High $19,498.45 | Facility | 50 · Both sides | $12,302.69 | $16,982.44 | $19,498.45 |
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
$1,479
AK $3,162TX $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.