How much rates vary
Facilitymedian $776 · 10th to 90th $525 to $9,550Professionalmedian $724 · 10th to 90th $407 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 $5,128.61 Median $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | None | $501.19 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,918.31 Typical High $9,549.93 | Facility | None | $1,000.00 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $1,096.48 | Professional | None | $426.58 | $676.08 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,071.52 | Professional | None | $724.44 | $851.14 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $17,378.01 | Facility | None | $645.65 | $1,071.52 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $933.25 | Professional | None | $549.54 | $616.60 | $933.25 |
Pacific Source Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $794.33 | Facility | None | $446.68 | $741.31 | $794.33 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $6,309.57 Typical High $9,549.93 | Facility | None | $758.58 | $6,309.57 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $724.44 Typical High $1,096.48 | Professional | None | $79.43 | $724.44 | $1,096.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $25,118.86 Typical High $28,183.83 | Facility | None | $4,570.88 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,023.29 | Professional | None | $758.58 | $794.33 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $1,148.15 | Professional | None | $446.68 | $707.95 | $1,148.15 |
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 $223.87 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $223.87 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $89.13 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $331.13 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $309.03 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $109.65 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $407.38 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $380.19 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,760.83 Median $37,153.52 Typical High $42,657.95 | Facility | 50 · Both sides | $6,760.83 | $37,153.52 | $42,657.95 |
Where Oregon sits
The same service costs 7.2 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· 11th of 51
$741
AK $1,622TX $224
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.