How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,259 to $10,715Professionalmedian $1,950 · 10th to 90th $1,122 to $3,020
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,412.54 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $8,709.64 Typical High $12,022.64 | Facility | None | $870.96 | $8,709.64 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,819.70 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,238.72 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,187.76 Typical High $7,943.28 | Facility | None | $1,548.82 | $2,187.76 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,548.82 | $1,548.82 | $2,454.71 |
Pacific Source Setting Facility Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,187.76 | Facility | None | $1,258.93 | $1,819.70 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $7,943.28 Typical High $11,220.18 | Facility | None | $1,023.29 | $7,943.28 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,905.46 Typical High $3,019.95 | Professional | None | $79.43 | $1,905.46 | $3,019.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,782.79 Median $25,118.86 Typical High $28,183.83 | Facility | None | $17,782.79 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,884.03 | Professional | None | $2,137.96 | $2,238.72 | $2,884.03 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,258.93 | $1,949.84 | $3,235.94 |
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 $630.96 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $630.96 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $309.03 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,071.52 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $26,915.35 Median $37,153.52 Typical High $42,657.95 | Facility | 50 · Both sides | $26,915.35 | $37,153.52 | $42,657.95 |
Where Oregon sits
The same service costs 13.8 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
$2,042
AK $4,467TX $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.