How much rates vary
Facilitymedian $776 · 10th to 90th $468 to $4,169Professionalmedian $759 · 10th to 90th $437 to $1,148
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $575.44 | Professional | None | $537.03 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,090.30 Typical High $4,168.69 | Facility | None | $660.69 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $1,174.90 | Professional | None | $446.68 | $707.95 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,096.48 | Professional | None | $758.58 | $891.25 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,096.48 Typical High $7,943.28 | Facility | None | $645.65 | $1,096.48 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $1,000.00 | Professional | None | $575.44 | $630.96 | $1,000.00 |
Pacific Source Setting Facility Modifier None Typical Low $467.74 Median $741.31 Typical High $831.76 | Facility | None | $467.74 | $741.31 | $831.76 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $4,168.69 | Facility | None | $645.65 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $741.31 Typical High $1,148.15 | Professional | None | $79.43 | $741.31 | $1,148.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $11,220.18 Typical High $12,882.50 | Facility | None | $8,128.31 | $11,220.18 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,096.48 | Professional | None | $812.83 | $851.14 | $1,096.48 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,230.27 | Professional | None | $457.09 | $724.44 | $1,230.27 |
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 $234.42 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $95.50 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $354.81 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $70.79 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $46.77 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $331.13 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $117.49 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $436.52 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $407.38 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $16,982.44 Typical High $19,498.45 | Facility | 50 · Both sides | $12,302.69 | $16,982.44 | $19,498.45 |
Where Oregon sits
The same service costs 8.1 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
$759
AK $1,698TX $209
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.