How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,479 to $19,055Professionalmedian $2,344 · 10th to 90th $1,318 to $3,548
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 $1,659.59 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,659.59 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $16,595.87 Typical High $22,908.68 | Facility | None | $1,230.27 | $16,595.87 | $22,908.68 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $3,630.78 | Professional | None | $1,348.96 | $2,137.96 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,290.87 | $2,691.53 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $1,819.70 Median $3,467.37 Typical High $18,620.87 | Facility | None | $1,819.70 | $3,467.37 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,819.70 | $1,995.26 | $2,951.21 |
Pacific Source Setting Facility Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $2,630.27 | Facility | None | $1,479.11 | $2,398.83 | $2,630.27 |
Providence Setting Facility Modifier None Typical Low $1,288.25 Median $15,135.61 Typical High $22,908.68 | Facility | None | $1,288.25 | $15,135.61 | $22,908.68 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,344.23 Typical High $3,630.78 | Professional | None | $79.43 | $2,344.23 | $3,630.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $33,884.42 Median $45,708.82 Typical High $56,234.13 | Facility | None | $33,884.42 | $45,708.82 | $56,234.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $3,467.37 | Professional | None | $2,511.89 | $2,630.27 | $3,467.37 |
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 $1,479.11 Median $2,290.87 Typical High $3,801.89 | Professional | None | $1,479.11 | $2,290.87 | $3,801.89 |
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 $741.31 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $741.31 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $295.12 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,122.02 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $147.91 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $912.01 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $363.08 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $51,286.14 Median $69,183.10 Typical High $85,113.80 | Facility | 50 · Both sides | $51,286.14 | $69,183.10 | $85,113.80 |
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· 10th of 51
$2,455
AK $5,248TX $708
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.