How much rates vary
Facilitymedian $1,698 · 10th to 90th $1,023 to $7,413Professionalmedian $1,660 · 10th to 90th $891 to $2,512
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,128.61 Typical High $6,918.31 | Facility | None | $891.25 | $5,128.61 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,548.82 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,698.24 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $8,709.64 | Facility | None | $1,288.25 | $2,344.23 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,380.38 | $2,290.87 |
Pacific Source Setting Facility Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $1,737.80 | Facility | None | $1,023.29 | $1,659.59 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $4,570.88 Typical High $6,918.31 | Facility | None | $912.01 | $4,570.88 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,621.81 Typical High $2,511.89 | Professional | None | $79.43 | $1,621.81 | $2,511.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,589.25 Median $17,782.79 Typical High $20,417.38 | Facility | None | $12,589.25 | $17,782.79 | $20,417.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,659.59 | $1,737.80 | $2,570.40 |
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 $1,288.25 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,819.70 | $3,019.95 |
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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Where Oregon sits
The same service costs 5.6 times more in Alaska 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· 13th of 51
$1,698
AK $3,548UT $631
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.