How much rates vary
Facilitymedian $1,202 · 10th to 90th $724 to $7,762Professionalmedian $1,096 · 10th to 90th $575 to $1,698
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 $724.44 Median $933.25 Typical High $933.25 | Professional | None | $724.44 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,691.53 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,691.53 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,698.24 | Professional | None | $724.44 | $1,023.29 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,288.25 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $1,621.81 Typical High $17,378.01 | Facility | None | $954.99 | $1,621.81 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,548.82 | Professional | None | $870.96 | $954.99 | $1,548.82 |
Pacific Source Setting Facility Modifier None Typical Low $707.95 Median $1,122.02 Typical High $1,258.93 | Facility | None | $707.95 | $1,122.02 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $2,454.71 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,454.71 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,096.48 Typical High $1,819.70 | Professional | None | $79.43 | $1,096.48 | $1,819.70 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $9,772.37 Typical High $11,220.18 | Facility | None | $6,918.31 | $9,772.37 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,258.93 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,905.46 | Professional | None | $891.25 | $1,122.02 | $1,905.46 |
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 $338.84 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $338.84 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $134.90 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $501.19 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $100.00 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $67.61 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $467.74 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $173.78 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $660.69 |
Where Oregon sits
The same service costs 5.6 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
$1,148
AK $2,512TX $447
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.