How much rates vary
Facilitymedian $1,202 · 10th to 90th $832 to $9,333Professionalmedian $1,096 · 10th to 90th $589 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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $912.01 | Professional | None | $630.96 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $4,466.84 | Facility | None | $1,230.27 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,659.59 | Professional | None | $724.44 | $1,000.00 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,230.27 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $912.01 Median $1,621.81 Typical High $18,620.87 | Facility | None | $912.01 | $1,621.81 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,548.82 | Professional | None | $891.25 | $954.99 | $1,548.82 |
Pacific Source Setting Facility Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,230.27 | Facility | None | $707.95 | $1,071.52 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $3,019.95 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,019.95 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,071.52 Typical High $1,819.70 | Professional | None | $79.43 | $1,071.52 | $1,819.70 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $15,135.61 | Facility | None | $9,332.54 | $12,302.69 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,258.93 | $1,659.59 |
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 $891.25 Median $1,122.02 Typical High $1,862.09 | Professional | None | $891.25 | $1,122.02 | $1,862.09 |
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 $331.13 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $331.13 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $134.90 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $501.19 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $100.00 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $67.61 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $467.74 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $416.87 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $169.82 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $630.96 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $645.65 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,803.84 Median $18,620.87 Typical High $22,908.68 | Facility | 50 · Both sides | $13,803.84 | $18,620.87 | $22,908.68 |
Where Oregon sits
The same service costs 5.9 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
$1,122
AK $2,512TX $427
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.