How much rates vary
Facilitymedian $1,380 · 10th to 90th $912 to $5,754Professionalmedian $1,318 · 10th to 90th $724 to $2,042
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,000.00 | Professional | None | $724.44 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $4,365.16 | Facility | None | $1,230.27 | $3,235.94 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,949.84 | Professional | None | $977.24 | $1,258.93 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,380.38 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $18,620.87 | Facility | None | $1,096.48 | $1,905.46 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,047.13 | $1,905.46 |
Pacific Source Setting Facility Modifier None Typical Low $812.83 Median $1,348.96 Typical High $1,412.54 | Facility | None | $812.83 | $1,348.96 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $1,071.52 Median $2,951.21 Typical High $4,365.16 | Facility | None | $1,071.52 | $2,951.21 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,288.25 Typical High $2,041.74 | Professional | None | $79.43 | $1,288.25 | $2,041.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $9,332.54 Typical High $13,803.84 | Facility | None | $5,248.07 | $9,332.54 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,412.54 | $2,089.30 |
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 $1,047.13 Median $1,479.11 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,479.11 | $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 $467.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $467.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $190.55 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $707.95 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $660.69 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Where Oregon sits
The same service costs 5.8 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
$1,349
AK $2,818UT $490
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.