How much rates vary
Facilitymedian $1,820 · 10th to 90th $1,148 to $12,589Professionalmedian $1,778 · 10th to 90th $977 to $2,754
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 $1,000.00 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $9,332.54 Typical High $12,882.50 | Facility | None | $1,000.00 | $9,332.54 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,659.59 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,584.89 | $1,819.70 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,511.89 Typical High $17,378.01 | Facility | None | $1,445.44 | $2,511.89 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,412.54 | $2,511.89 |
Pacific Source Setting Facility Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $1,905.46 | Facility | None | $1,096.48 | $1,819.70 | $1,905.46 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $8,511.38 Typical High $12,882.50 | Facility | None | $1,047.13 | $8,511.38 | $12,882.50 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,737.80 Typical High $2,754.23 | Professional | None | $79.43 | $1,737.80 | $2,754.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,589.25 Median $22,908.68 Typical High $37,153.52 | Facility | None | $12,589.25 | $22,908.68 | $37,153.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,778.28 | $1,905.46 | $2,818.38 |
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 $1,380.38 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,380.38 | $2,041.74 | $3,235.94 |
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 $645.65 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $645.65 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $257.04 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $933.25 |
Where Oregon sits
The same service costs 6.3 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· 11th of 51
$1,820
OK $4,169UT $661
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.