How much rates vary
Facilitymedian $1,380 · 10th to 90th $1,023 to $8,913Professionalmedian $1,288 · 10th to 90th $692 to $1,950
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 $13,489.63 Typical High $33,884.42 | Facility | None | $5,128.61 | $13,489.63 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,096.48 | Professional | None | $794.33 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,949.84 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,949.84 | Professional | None | $870.96 | $1,174.90 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,380.38 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $33,884.42 | Facility | None | $1,174.90 | $1,905.46 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,096.48 | $1,698.24 |
Pacific Source Setting Facility Modifier None Typical Low $831.76 Median $1,288.25 Typical High $1,412.54 | Facility | None | $831.76 | $1,288.25 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $1,348.96 Median $5,128.61 Typical High $7,762.47 | Facility | None | $1,348.96 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,288.25 Typical High $2,089.30 | Professional | None | $79.43 | $1,288.25 | $2,089.30 |
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 $1,348.96 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,412.54 | $1,905.46 |
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 $1,047.13 Median $1,288.25 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,288.25 | $2,187.76 |
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 $389.05 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $389.05 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $154.88 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $588.84 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $117.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $77.62 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $549.54 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $501.19 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $199.53 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $758.58 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $758.58 |
Where Oregon sits
The same service costs 6.3 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· 9th of 51
$1,318
AK $2,884TX $457
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.