How much rates vary
Facilitymedian $692 · 10th to 90th $468 to $5,248Professionalmedian $525 · 10th to 90th $288 to $912
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 $537.03 Median $3,890.45 Typical High $8,709.64 | Facility | None | $537.03 | $3,890.45 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $630.96 | Professional | None | $239.88 | $407.38 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,905.46 Typical High $2,570.40 | Facility | None | $891.25 | $1,905.46 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $933.25 | Professional | None | $338.84 | $549.54 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $851.14 | Professional | None | $416.87 | $588.84 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $7,943.28 | Facility | None | $467.74 | $776.25 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $524.81 Typical High $977.24 | Professional | None | $275.42 | $524.81 | $977.24 |
Pacific Source Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $741.31 | Facility | None | $426.58 | $660.69 | $741.31 |
Providence Setting Facility Modifier None Typical Low $524.81 Median $1,513.56 Typical High $2,454.71 | Facility | None | $524.81 | $1,513.56 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $912.01 | Professional | None | $79.43 | $562.34 | $912.01 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,244.36 Typical High $8,128.31 | Facility | None | $5,248.07 | $7,244.36 | $8,128.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $891.25 | Professional | None | $436.52 | $645.65 | $891.25 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $380.19 Median $630.96 Typical High $977.24 | Professional | None | $380.19 | $630.96 | $977.24 |
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 $162.18 Median $162.18 Typical High $263.03 | Professional | 52 · Reduced service | $162.18 | $162.18 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $104.71 | Professional | 53 · Discontinued | $66.07 | $66.07 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $245.47 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $77.62 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $52.48 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $186.21 Typical High $263.03 | Professional | 52 · Reduced service | $162.18 | $186.21 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $104.71 | Professional | 53 · Discontinued | $66.07 | $66.07 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $245.47 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $77.62 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $52.48 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $52.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $363.08 |
Where Oregon sits
The same service costs 4.6 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· 7th of 51
$617
AK $1,259UT $275
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.