How much rates vary
Facilitymedian $692 · 10th to 90th $468 to $5,012Professionalmedian $661 · 10th to 90th $363 to $1,023
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 $457.09 Median $489.78 Typical High $489.78 | Professional | None | $457.09 | $489.78 | $489.78 |
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 $467.74 Median $630.96 Typical High $977.24 | Professional | None | $467.74 | $630.96 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $851.14 | Professional | None | $602.56 | $691.83 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $933.25 Typical High $7,943.28 | Facility | None | $549.54 | $933.25 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $954.99 | Professional | None | $489.78 | $549.54 | $954.99 |
Pacific Source Setting Facility Modifier None Typical Low $398.11 Median $676.08 Typical High $707.95 | Facility | None | $398.11 | $676.08 | $707.95 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $4,365.16 | Facility | None | $549.54 | $2,884.03 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $630.96 Typical High $1,023.29 | Professional | None | $79.43 | $630.96 | $1,023.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $12,022.64 Typical High $13,803.84 | Facility | None | $5,754.40 | $12,022.64 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,047.13 | Professional | None | $660.69 | $707.95 | $1,047.13 |
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 $512.86 Median $741.31 Typical High $1,202.26 | Professional | None | $512.86 | $741.31 | $1,202.26 |
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 $229.09 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $229.09 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $338.84 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $346.74 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,511.38 Median $18,197.01 Typical High $20,892.96 | Facility | 50 · Both sides | $8,511.38 | $18,197.01 | $20,892.96 |
Where Oregon sits
The same service costs 6.9 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· 12th of 51
$692
AK $1,905UT $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.