How much rates vary
Facilitymedian $1,622 · 10th to 90th $1,000 to $8,913Professionalmedian $1,549 · 10th to 90th $813 to $2,455
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 $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | None | $933.25 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,230.27 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,513.56 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,621.81 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,187.76 Typical High $18,620.87 | Facility | None | $1,318.26 | $2,187.76 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,258.93 | $2,238.72 |
Pacific Source Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $1,659.59 | Facility | None | $912.01 | $1,479.11 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $7,762.47 | Facility | None | $1,230.27 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,479.11 Typical High $2,398.83 | Professional | None | $79.43 | $1,479.11 | $2,398.83 |
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 $1,584.89 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,584.89 | $1,659.59 | $2,511.89 |
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 $1,174.90 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,621.81 | $2,884.03 |
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 $467.74 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $467.74 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $186.21 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $707.95 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $141.25 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $93.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $660.69 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $891.25 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $21,877.62 Median $30,199.52 Typical High $34,673.69 | Facility | 50 · Both sides | $21,877.62 | $30,199.52 | $34,673.69 |
Where Oregon sits
The same service costs 7.4 times more in Oklahoma 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· 12th of 51
$1,585
OK $3,890TX $525
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.