How much rates vary
Facilitymedian $1,514 · 10th to 90th $871 to $5,623Professionalmedian $1,413 · 10th to 90th $832 to $2,239
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 $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | None | $933.25 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $4,168.69 | Facility | None | $891.25 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $2,290.87 | Professional | None | $870.96 | $1,380.38 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,737.80 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $8,709.64 | Facility | None | $1,288.25 | $2,041.74 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,202.26 | $1,905.46 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,445.44 Typical High $1,659.59 | Facility | None | $891.25 | $1,445.44 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $2,754.23 Typical High $4,168.69 | Facility | None | $912.01 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,412.54 Typical High $2,290.87 | Professional | None | $79.43 | $1,412.54 | $2,290.87 |
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 $1,584.89 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,584.89 | $1,659.59 | $2,187.76 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $2,398.83 | Professional | None | $891.25 | $1,380.38 | $2,398.83 |
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 $467.74 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $467.74 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $141.25 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $93.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
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· 10th of 51
$1,479
AK $3,388TX $407
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.