How much rates vary
Facilitymedian $1,023 · 10th to 90th $617 to $3,631Professionalmedian $776 · 10th to 90th $501 to $1,259
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $776.25 | Professional | None | $380.19 | $524.81 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $1,905.46 | Facility | None | $1,000.00 | $1,412.54 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,288.25 | Professional | None | $537.03 | $776.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,288.25 | Professional | None | $691.83 | $933.25 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $1,096.48 Typical High $13,803.84 | Facility | None | $741.31 | $1,096.48 | $13,803.84 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,071.52 | Professional | None | $524.81 | $776.25 | $1,071.52 |
Pacific Source Setting Facility Modifier None Typical Low $616.60 Median $1,023.29 Typical High $1,047.13 | Facility | None | $616.60 | $1,023.29 | $1,047.13 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,318.26 Typical High $1,905.46 | Facility | None | $776.25 | $1,318.26 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $776.25 Typical High $1,288.25 | Professional | None | $79.43 | $776.25 | $1,288.25 |
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 $707.95 Median $1,000.00 Typical High $1,096.48 | Professional | None | $707.95 | $1,000.00 | $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 $549.54 Median $851.14 Typical High $1,380.38 | Professional | None | $549.54 | $851.14 | $1,380.38 |
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 $263.03 Median $263.03 Typical High $380.19 | Professional | 52 · Reduced service | $263.03 | $263.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $154.88 | Professional | 53 · Discontinued | $104.71 | $104.71 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | 54 · Surgery only | $389.05 | $389.05 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $114.82 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $77.62 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $263.03 Typical High $380.19 | Professional | 52 · Reduced service | $263.03 | $263.03 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $154.88 | Professional | 53 · Discontinued | $104.71 | $104.71 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | 54 · Surgery only | $389.05 | $389.05 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $114.82 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $77.62 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $77.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $537.03 |
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 4.8 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
$813
AK $1,549UT $324
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.