How much rates vary
Facilitymedian $1,072 · 10th to 90th $676 to $7,943Professionalmedian $1,072 · 10th to 90th $575 to $1,660
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 $5,128.61 Median $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $776.25 | Professional | None | $691.83 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $3,311.31 Typical High $4,466.84 | Facility | None | $1,412.54 | $3,311.31 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,513.56 | Professional | None | $724.44 | $977.24 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,148.15 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $24,547.09 | Facility | None | $851.14 | $1,479.11 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,548.82 | Professional | None | $776.25 | $891.25 | $1,548.82 |
Pacific Source Setting Facility Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,122.02 | Facility | None | $645.65 | $1,023.29 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $977.24 Median $3,019.95 Typical High $4,466.84 | Facility | None | $977.24 | $3,019.95 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,023.29 Typical High $1,621.81 | Professional | None | $79.43 | $1,023.29 | $1,621.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $15,135.61 | Facility | None | $9,332.54 | $12,302.69 | $15,135.61 |
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 $812.83 Median $1,148.15 Typical High $1,949.84 | Professional | None | $812.83 | $1,148.15 | $1,949.84 |
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 $346.74 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $346.74 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $512.86 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $69.18 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $478.63 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $389.05 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $154.88 | $154.88 | $154.88 |
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 $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
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 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,803.84 Median $18,620.87 Typical High $22,908.68 | Facility | 50 · Both sides | $13,803.84 | $18,620.87 | $22,908.68 |
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
$1,072
OK $3,631UT $417
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.