How much rates vary
Facilitymedian $1,413 · 10th to 90th $933 to $8,318Professionalmedian $1,349 · 10th to 90th $741 to $2,089
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 $758.58 Median $1,023.29 Typical High $1,023.29 | Professional | None | $758.58 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $5,128.61 Typical High $6,918.31 | Facility | None | $1,000.00 | $5,128.61 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,949.84 | Professional | None | $977.24 | $1,288.25 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,412.54 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $17,378.01 | Facility | None | $1,122.02 | $1,995.26 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $2,137.96 | Professional | None | $812.83 | $1,071.52 | $2,137.96 |
Pacific Source Setting Facility Modifier None Typical Low $831.76 Median $1,348.96 Typical High $1,445.44 | Facility | None | $831.76 | $1,348.96 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $4,570.88 Typical High $6,918.31 | Facility | None | $1,000.00 | $4,570.88 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,318.26 Typical High $2,089.30 | Professional | None | $79.43 | $1,318.26 | $2,089.30 |
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 $1,380.38 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,380.38 | $1,445.44 | $2,137.96 |
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 $1,047.13 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,513.56 | $2,454.71 |
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 $489.78 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $489.78 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $741.31 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $147.91 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $691.83 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Where Oregon sits
The same service costs 8.7 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· 13th of 51
$1,380
OK $4,365UT $501
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.