How much rates vary
Facilitymedian $891 · 10th to 90th $617 to $8,128Professionalmedian $832 · 10th to 90th $437 to $1,288
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 $794.33 Median $8,912.51 Typical High $18,620.87 | Facility | None | $794.33 | $8,912.51 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $660.69 | Professional | None | $436.52 | $645.65 | $660.69 |
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 $616.60 Median $812.83 Typical High $1,258.93 | Professional | None | $616.60 | $812.83 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,096.48 | Professional | None | $776.25 | $891.25 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $794.33 Median $1,096.48 Typical High $18,620.87 | Facility | None | $794.33 | $1,096.48 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,202.26 | Professional | None | $467.74 | $660.69 | $1,202.26 |
Pacific Source Setting Facility Modifier None Typical Low $524.81 Median $851.14 Typical High $912.01 | Facility | None | $524.81 | $851.14 | $912.01 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $2,951.21 Typical High $4,365.16 | Facility | None | $870.96 | $2,951.21 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $831.76 Typical High $1,318.26 | Professional | None | $79.43 | $831.76 | $1,318.26 |
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 $870.96 Median $912.01 Typical High $1,348.96 | Professional | None | $870.96 | $912.01 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,584.89 | Professional | None | $660.69 | $954.99 | $1,584.89 |
13 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 $302.00 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $302.00 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $120.23 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $457.09 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $91.20 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $60.26 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $426.58 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,489.63 Median $18,197.01 Typical High $20,892.96 | Facility | 50 · Both sides | $13,489.63 | $18,197.01 | $20,892.96 |
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
$871
OK $2,951UT $339
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.