How much rates vary
Facilitymedian $891 · 10th to 90th $562 to $4,467Professionalmedian $676 · 10th to 90th $427 to $1,072
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 $5,623.41 Typical High $8,709.64 | Facility | None | $3,890.45 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $676.08 | Professional | None | $323.59 | $478.63 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,412.54 Typical High $1,905.46 | Facility | None | $812.83 | $1,412.54 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,122.02 | Professional | None | $467.74 | $676.08 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,148.15 | Professional | None | $588.84 | $812.83 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $977.24 Typical High $7,943.28 | Facility | None | $630.96 | $977.24 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $954.99 | Professional | None | $436.52 | $660.69 | $954.99 |
Pacific Source Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $912.01 | Facility | None | $537.03 | $891.25 | $912.01 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $1,202.26 Typical High $1,905.46 | Facility | None | $676.08 | $1,202.26 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $676.08 Typical High $1,122.02 | Professional | None | $79.43 | $676.08 | $1,122.02 |
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 $602.56 Median $870.96 Typical High $933.25 | Professional | None | $602.56 | $870.96 | $933.25 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,244.36 | Facility | None | $602.56 | $1,000.00 | $7,244.36 |
United Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,202.26 | Professional | None | $457.09 | $741.31 | $1,202.26 |
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 $218.78 Median $218.78 Typical High $338.84 | Professional | 52 · Reduced service | $218.78 | $218.78 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $134.90 | Professional | 53 · Discontinued | $89.13 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $512.86 | Professional | 54 · Surgery only | $331.13 | $331.13 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $102.33 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $67.61 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $218.78 Typical High $338.84 | Professional | 52 · Reduced service | $218.78 | $218.78 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $134.90 | Professional | 53 · Discontinued | $89.13 | $89.13 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $512.86 | Professional | 54 · Surgery only | $331.13 | $331.13 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $102.33 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $67.61 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $478.63 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,165.95 Median $8,511.38 Typical High $9,772.37 | Facility | 50 · Both sides | $6,165.95 | $8,511.38 | $9,772.37 |
Where Oregon sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 7th of 51
$708
AK $1,413UT $288
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.