How much rates vary
Facilitymedian $1,622 · 10th to 90th $955 to $12,882Professionalmedian $1,585 · 10th to 90th $851 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 $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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $23,988.33 | Facility | None | $549.54 | $1,000.00 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,479.11 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,621.81 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,238.72 Typical High $18,620.87 | Facility | None | $1,202.26 | $2,238.72 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,258.93 | $2,187.76 |
Pacific Source Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $1,659.59 | Facility | None | $954.99 | $1,584.89 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,023.29 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,513.56 Typical High $2,398.83 | Professional | None | $79.43 | $1,513.56 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,584.89 | $1,659.59 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,511.89 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,737.80 | $2,884.03 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Where Oregon sits
The same service costs 6.2 times more in Oklahoma 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· 12th of 51
$1,585
OK $3,631UT $589
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.