How much rates vary
Facilitymedian $1,622 · 10th to 90th $1,047 to $8,318Professionalmedian $1,445 · 10th to 90th $891 to $2,399
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 $1,023.29 Median $1,023.29 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,023.29 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,000.00 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $2,511.89 | Professional | None | $891.25 | $1,412.54 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,412.54 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $17,378.01 | Facility | None | $1,122.02 | $1,995.26 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,995.26 | Professional | None | $977.24 | $1,380.38 | $1,995.26 |
Pacific Source Setting Facility Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $1,862.09 | Facility | None | $1,000.00 | $1,548.82 | $1,862.09 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,000.00 | $4,897.79 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,445.44 Typical High $2,454.71 | Professional | None | $79.43 | $1,445.44 | $2,454.71 |
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 $1,288.25 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,778.28 | $2,454.71 |
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 $1,047.13 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,047.13 | $1,698.24 | $2,754.23 |
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 $512.86 Median $512.86 Typical High $724.44 | Professional | 52 · Reduced service | $512.86 | $512.86 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $288.40 | Professional | 53 · Discontinued | $204.17 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $776.25 | $776.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $218.78 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $512.86 Typical High $724.44 | Professional | 52 · Reduced service | $512.86 | $512.86 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $288.40 | Professional | 53 · Discontinued | $204.17 | $204.17 | $288.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $776.25 | $776.25 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $218.78 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $144.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $1,000.00 |
Where Oregon sits
The same service costs 5.2 times more in Alaska 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· 6th of 51
$1,585
AK $3,548UT $676
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.