How much rates vary
Facilitymedian $1,585 · 10th to 90th $955 to $8,128Professionalmedian $1,479 · 10th to 90th $871 to $2,291
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 $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,202.26 | $1,202.26 |
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 $891.25 Median $1,412.54 Typical High $2,398.83 | Professional | None | $891.25 | $1,412.54 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,819.70 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $17,378.01 | Facility | None | $1,412.54 | $2,137.96 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,288.25 | $1,949.84 |
Pacific Source Setting Facility Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,698.24 | Facility | None | $933.25 | $1,479.11 | $1,698.24 |
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 $1,479.11 Typical High $2,344.23 | Professional | None | $79.43 | $1,479.11 | $2,344.23 |
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 $1,621.81 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,698.24 | $2,238.72 |
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 $977.24 Median $1,445.44 Typical High $2,454.71 | Professional | None | $977.24 | $1,445.44 | $2,454.71 |
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 $478.63 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $478.63 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $194.98 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $724.44 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $97.72 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $676.08 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $239.88 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $912.01 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $851.14 |
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· 10th of 51
$1,549
AK $3,467TX $468
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.