How much rates vary
Facilitymedian $1,202 · 10th to 90th $759 to $7,762Professionalmedian $1,175 · 10th to 90th $589 to $1,862
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 $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,000.00 | Professional | None | $588.84 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,623.41 Typical High $7,762.47 | Facility | None | $891.25 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,862.09 | Professional | None | $870.96 | $1,174.90 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,288.25 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $8,709.64 | Facility | None | $1,000.00 | $1,698.24 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,698.24 | Professional | None | $691.83 | $1,000.00 | $1,698.24 |
Pacific Source Setting Facility Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,318.26 | Facility | None | $724.44 | $1,148.15 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $5,128.61 Typical High $7,762.47 | Facility | None | $912.01 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,148.15 Typical High $1,905.46 | Professional | None | $79.43 | $1,148.15 | $1,905.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $20,417.38 Typical High $23,442.29 | Facility | None | $14,454.40 | $20,417.38 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,318.26 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,238.72 | Professional | None | $912.01 | $1,258.93 | $2,238.72 |
12 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 $371.54 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $371.54 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $147.91 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $562.34 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $112.20 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $74.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $524.81 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Where Oregon sits
The same service costs 8.1 times more in Oklahoma 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· 16th of 51
$1,202
OK $3,548UT $437
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.