How much rates vary
Facilitymedian $1,230 · 10th to 90th $724 to $4,786Professionalmedian $1,148 · 10th to 90th $646 to $1,738
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | None | $812.83 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,238.72 | Facility | None | $891.25 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,778.28 | Professional | None | $676.08 | $1,071.52 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,318.26 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,778.28 Typical High $8,709.64 | Facility | None | $891.25 | $1,778.28 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,445.44 | Professional | None | $758.58 | $954.99 | $1,445.44 |
Pacific Source Setting Facility Modifier None Typical Low $724.44 Median $1,202.26 Typical High $1,288.25 | Facility | None | $724.44 | $1,202.26 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $1,584.89 Typical High $2,238.72 | Facility | None | $891.25 | $1,584.89 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,148.15 Typical High $1,778.28 | Professional | None | $79.43 | $1,148.15 | $1,778.28 |
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 $1,230.27 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,288.25 | $1,659.59 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,862.09 | Professional | None | $724.44 | $1,148.15 | $1,862.09 |
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 $363.08 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
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· 8th of 51
$1,202
AK $2,570TX $347
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.