How much rates vary
Facilitymedian $1,047 · 10th to 90th $437 to $12,589Professionalmedian $1,072 · 10th to 90th $79 to $1,862
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 $977.24 Median $8,912.51 Typical High $18,620.87 | Facility | None | $977.24 | $8,912.51 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $794.33 | Professional | None | $630.96 | $794.33 | $794.33 |
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 $776.25 Median $1,000.00 Typical High $1,548.82 | Professional | None | $776.25 | $1,000.00 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,348.96 | Professional | None | $954.99 | $1,096.48 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $7,943.28 Typical High $18,620.87 | Facility | None | $977.24 | $7,943.28 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,000.00 | Professional | None | $630.96 | $794.33 | $1,000.00 |
Pacific Source Setting Facility Modifier None Typical Low $407.38 Median $676.08 Typical High $724.44 | Facility | None | $407.38 | $676.08 | $724.44 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $3,090.30 Typical High $4,677.35 | Facility | None | $1,047.13 | $3,090.30 | $4,677.35 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $812.83 Typical High $1,621.81 | Professional | None | $79.43 | $812.83 | $1,621.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,912.51 Median $12,589.25 Typical High $13,803.84 | Facility | None | $8,912.51 | $12,589.25 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,122.02 | $1,659.59 |
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 $1,862.09 Typical High $2,630.27 | Professional | None | $1,047.13 | $1,862.09 | $2,630.27 |
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 $380.19 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $380.19 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $151.36 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $575.44 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $114.82 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $537.03 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $398.11 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $549.54 |
Where Oregon sits
The same service costs 7.4 times more in Oklahoma than in New York. 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· 26th of 51
$1,072
OK $3,802NY $513
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.