How much rates vary
Facilitymedian $1,585 · 10th to 90th $1,047 to $8,511Professionalmedian $1,549 · 10th to 90th $794 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 $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 $794.33 Median $1,148.15 Typical High $1,174.90 | Professional | None | $794.33 | $1,148.15 | $1,174.90 |
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 $1,122.02 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,445.44 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,584.89 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $17,378.01 | Facility | None | $1,288.25 | $2,187.76 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $2,398.83 | Professional | None | $933.25 | $1,230.27 | $2,398.83 |
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 $1,047.13 Median $2,884.03 Typical High $4,365.16 | Facility | None | $1,047.13 | $2,884.03 | $4,365.16 |
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 $8,912.51 Median $12,022.64 Typical High $13,803.84 | Facility | None | $8,912.51 | $12,022.64 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,548.82 | $1,621.81 | $2,454.71 |
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 $1,202.26 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,698.24 | $2,818.38 |
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 $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $562.34 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $223.87 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $831.76 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $169.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $776.25 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Where Oregon sits
The same service costs 6.6 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
$1,585
OK $3,802UT $575
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.