How much rates vary
Facilitymedian $1,349 · 10th to 90th $813 to $4,677Professionalmedian $1,259 · 10th to 90th $724 to $1,950
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 $891.25 Median $1,000.00 Typical High $1,000.00 | Professional | None | $891.25 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,090.30 Typical High $4,168.69 | Facility | None | $870.96 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,995.26 | Professional | None | $758.58 | $1,202.26 | $1,995.26 |
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 $1,047.13 Median $1,584.89 Typical High $7,943.28 | Facility | None | $1,047.13 | $1,584.89 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,071.52 | $1,621.81 |
Pacific Source Setting Facility Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,412.54 | Facility | None | $812.83 | $1,258.93 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $2,754.23 Typical High $3,981.07 | Facility | None | $1,023.29 | $2,754.23 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,258.93 Typical High $1,995.26 | Professional | None | $79.43 | $1,258.93 | $1,995.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $21,379.62 Typical High $29,512.09 | Facility | None | $6,918.31 | $21,379.62 | $29,512.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,445.44 | $1,905.46 |
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 $794.33 Median $1,258.93 Typical High $2,089.30 | Professional | None | $794.33 | $1,258.93 | $2,089.30 |
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 $407.38 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $616.60 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $575.44 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
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· 11th of 51
$1,288
AK $2,951TX $151
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.