How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,349 to $8,128Professionalmedian $2,089 · 10th to 90th $1,122 to $3,020
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $4,073.80 Typical High $5,495.41 | Facility | None | $1,230.27 | $4,073.80 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,862.09 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,238.72 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,698.24 Median $3,090.30 Typical High $18,620.87 | Facility | None | $1,698.24 | $3,090.30 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,737.80 | $2,630.27 |
Pacific Source Setting Facility Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $2,290.87 | Facility | None | $1,318.26 | $2,089.30 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $1,288.25 Median $3,630.78 Typical High $5,495.41 | Facility | None | $1,288.25 | $3,630.78 | $5,495.41 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,089.30 Typical High $3,090.30 | Professional | None | $79.43 | $2,089.30 | $3,090.30 |
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 $2,137.96 Median $2,290.87 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,290.87 | $2,951.21 |
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 $1,445.44 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,445.44 | $2,041.74 | $3,311.31 |
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 $645.65 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,096.48 |
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 19.5 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· 8th of 51
$2,138
AK $4,571TX $234
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.