How much rates vary
Facilitymedian $1,445 · 10th to 90th $912 to $7,943Professionalmedian $1,413 · 10th to 90th $776 to $2,188
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 $776.25 Median $1,071.52 Typical High $1,071.52 | Professional | None | $776.25 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,235.94 Typical High $4,365.16 | Facility | None | $1,000.00 | $3,235.94 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,318.26 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,445.44 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $17,378.01 | Facility | None | $1,174.90 | $1,995.26 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $2,290.87 | Professional | None | $831.76 | $1,122.02 | $2,290.87 |
Pacific Source Setting Facility Modifier None Typical Low $870.96 Median $1,412.54 Typical High $1,513.56 | Facility | None | $870.96 | $1,412.54 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $4,365.16 | Facility | None | $1,000.00 | $2,884.03 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,380.38 Typical High $2,187.76 | Professional | None | $79.43 | $1,380.38 | $2,187.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $12,022.64 Typical High $13,803.84 | Facility | None | $5,754.40 | $12,022.64 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,513.56 | $2,238.72 |
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 $1,096.48 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,584.89 | $2,570.40 |
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 $501.19 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $501.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $758.58 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $707.95 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $794.33 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
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 $741.31 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $741.31 |
Where Oregon sits
The same service costs 7.9 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· 14th of 51
$1,445
OK $4,169UT $525
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.