How much rates vary
Facilitymedian $1,318 · 10th to 90th $813 to $10,000Professionalmedian $1,202 · 10th to 90th $631 to $1,820
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 $1,174.90 Median $10,232.93 Typical High $24,547.09 | Facility | None | $1,174.90 | $10,232.93 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $954.99 | Professional | None | $616.60 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $6,918.31 Typical High $9,549.93 | Facility | None | $870.96 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,122.02 Typical High $1,862.09 | Professional | None | $707.95 | $1,122.02 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,380.38 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $24,547.09 | Facility | None | $1,047.13 | $1,584.89 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,513.56 | Professional | None | $707.95 | $1,023.29 | $1,513.56 |
Pacific Source Setting Facility Modifier None Typical Low $776.25 Median $1,258.93 Typical High $1,348.96 | Facility | None | $776.25 | $1,258.93 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $6,165.95 Typical High $8,912.51 | Facility | None | $933.25 | $6,165.95 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,230.27 Typical High $1,862.09 | Professional | None | $79.43 | $1,230.27 | $1,862.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,912.51 Median $25,118.86 Typical High $28,183.83 | Facility | None | $8,912.51 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,380.38 | $1,778.28 |
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 $794.33 Median $1,230.27 Typical High $1,995.26 | Professional | None | $794.33 | $1,230.27 | $1,995.26 |
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 $389.05 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,489.63 Median $37,153.52 Typical High $42,657.95 | Facility | 50 · Both sides | $13,489.63 | $37,153.52 | $42,657.95 |
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· 9th of 51
$1,288
AK $2,754TX $372
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.