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 $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 $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,288.25 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,918.31 Typical High $9,549.93 | Facility | None | $1,000.00 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,659.59 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,737.80 | $2,041.74 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $17,378.01 | Facility | None | $1,905.46 | $2,754.23 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,548.82 | $2,290.87 |
Pacific Source Setting Facility Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $2,041.74 | Facility | None | $1,202.26 | $1,905.46 | $2,041.74 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $6,309.57 Typical High $9,549.93 | Facility | None | $1,047.13 | $6,309.57 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,862.09 Typical High $2,818.38 | Professional | None | $79.43 | $1,862.09 | $2,818.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,912.51 Median $25,118.86 Typical High $28,183.83 | Facility | None | $8,912.51 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,041.74 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,819.70 | $3,019.95 |
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 $575.44 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $575.44 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $114.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,000.00 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,489.63 Median $37,153.52 Typical High $42,657.95 | Facility | 50 · Both sides | $13,489.63 | $37,153.52 | $42,657.95 |
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· 9th of 51
$1,950
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.