How much rates vary
Facilitymedian $1,000 · 10th to 90th $537 to $7,943Professionalmedian $813 · 10th to 90th $437 to $1,413
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 $537.03 Median $7,943.28 Typical High $17,378.01 | Facility | None | $537.03 | $7,943.28 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $870.96 | Professional | None | $436.52 | $691.83 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $524.81 Typical High $1,000.00 | Facility | None | $416.87 | $524.81 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $831.76 Typical High $1,348.96 | Professional | None | $478.63 | $831.76 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,174.90 | Professional | None | $562.34 | $794.33 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $13,182.57 | Facility | None | $537.03 | $1,548.82 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $436.52 Median $724.44 Typical High $1,230.27 | Professional | None | $436.52 | $724.44 | $1,230.27 |
Pacific Source Setting Facility Modifier None Typical Low $630.96 Median $954.99 Typical High $1,479.11 | Facility | None | $630.96 | $954.99 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $645.65 Typical High $1,862.09 | Facility | None | $426.58 | $645.65 | $1,862.09 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $870.96 Typical High $1,445.44 | Professional | None | $79.43 | $870.96 | $1,445.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,317.64 Median $10,964.78 Typical High $12,882.50 | Facility | None | $8,317.64 | $10,964.78 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,479.11 | Professional | None | $616.60 | $933.25 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,071.52 Typical High $1,698.24 | Professional | None | $630.96 | $1,071.52 | $1,698.24 |
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 $213.80 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $213.80 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $87.10 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $323.59 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $64.57 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $43.65 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $302.00 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $269.15 Typical High $346.74 | Professional | 52 · Reduced service | $213.80 | $269.15 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $87.10 | $109.65 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $407.38 Typical High $524.81 | Professional | 54 · Surgery only | $323.59 | $407.38 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $81.28 Typical High $104.71 | Professional | 55 · Aftercare only | $64.57 | $81.28 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $43.65 | $54.95 | $70.79 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $380.19 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $302.00 | $380.19 | $489.78 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $16,595.87 Typical High $19,054.61 | Facility | 50 · Both sides | $12,302.69 | $16,595.87 | $19,054.61 |
Where Oregon sits
The same service costs 4.3 times more in Wisconsin 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· 7th of 51
$933
WI $1,862TX $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.