How much rates vary
Facilitymedian $977 · 10th to 90th $646 to $5,012Professionalmedian $955 · 10th to 90th $525 to $1,445
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | None | $660.69 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,235.94 Typical High $4,365.16 | Facility | None | $660.69 | $3,235.94 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,380.38 | Professional | None | $691.83 | $891.25 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,174.90 | Professional | None | $851.14 | $977.24 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $794.33 Median $1,348.96 Typical High $7,943.28 | Facility | None | $794.33 | $1,348.96 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,348.96 | Professional | None | $707.95 | $794.33 | $1,348.96 |
Pacific Source Setting Facility Modifier None Typical Low $575.44 Median $954.99 Typical High $1,000.00 | Facility | None | $575.44 | $954.99 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,884.03 Typical High $4,365.16 | Facility | None | $660.69 | $2,884.03 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $912.01 Typical High $1,445.44 | Professional | None | $79.43 | $912.01 | $1,445.44 |
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 $954.99 Median $1,000.00 Typical High $1,479.11 | Professional | None | $954.99 | $1,000.00 | $1,479.11 |
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 $741.31 Median $1,047.13 Typical High $1,737.80 | Professional | None | $741.31 | $1,047.13 | $1,737.80 |
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 $331.13 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $331.13 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $134.90 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $354.81 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $501.19 |
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 5.5 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
$977
AK $2,042UT $372
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.