How much rates vary
Facilitymedian $1,479 · 10th to 90th $977 to $10,233Professionalmedian $1,349 · 10th to 90th $724 to $2,089
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | None | $851.14 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,412.54 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $2,089.30 | Professional | None | $870.96 | $1,258.93 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,479.11 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,089.30 Typical High $24,547.09 | Facility | None | $1,174.90 | $2,089.30 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,148.15 | $1,778.28 |
Pacific Source Setting Facility Modifier None Typical Low $831.76 Median $1,380.38 Typical High $1,513.56 | Facility | None | $831.76 | $1,380.38 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $1,174.90 Median $5,128.61 Typical High $7,762.47 | Facility | None | $1,174.90 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,348.96 Typical High $2,187.76 | Professional | None | $79.43 | $1,348.96 | $2,187.76 |
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 $1,412.54 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,513.56 | $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 $1,071.52 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,318.26 | $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 $426.58 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $426.58 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $169.82 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $645.65 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $128.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $85.11 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $602.56 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $524.81 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $213.80 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $794.33 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $158.49 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $104.71 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $741.31 | $812.83 | $812.83 |
Where Oregon sits
The same service costs 6.2 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· 10th of 51
$1,380
AK $3,020TX $490
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.