How much rates vary
Facilitymedian $813 · 10th to 90th $575 to $7,586Professionalmedian $776 · 10th to 90th $427 to $1,202
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 $707.95 Median $8,317.64 Typical High $17,378.01 | Facility | None | $707.95 | $8,317.64 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $616.60 | Professional | None | $457.09 | $588.84 | $616.60 |
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 $562.34 Median $741.31 Typical High $1,148.15 | Professional | None | $562.34 | $741.31 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,000.00 | Professional | None | $707.95 | $812.83 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,000.00 Typical High $17,378.01 | Facility | None | $645.65 | $1,000.00 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $1,096.48 | Professional | None | $588.84 | $630.96 | $1,096.48 |
Pacific Source Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $812.83 | Facility | None | $467.74 | $776.25 | $812.83 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $2,884.03 Typical High $4,365.16 | Facility | None | $794.33 | $2,884.03 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $758.58 Typical High $1,202.26 | Professional | None | $79.43 | $758.58 | $1,202.26 |
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 $776.25 Median $831.76 Typical High $1,230.27 | Professional | None | $776.25 | $831.76 | $1,230.27 |
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 $602.56 Median $851.14 Typical High $1,412.54 | Professional | None | $602.56 | $851.14 | $1,412.54 |
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 $269.15 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $107.15 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $407.38 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $117.49 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $436.52 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $407.38 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,943.28 Median $14,125.38 Typical High $20,892.96 | Facility | 50 · Both sides | $7,943.28 | $14,125.38 | $20,892.96 |
Where Oregon sits
The same service costs 6.0 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· 12th of 51
$794
OK $1,862UT $309
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.