How much rates vary
Facilitymedian $355 · 10th to 90th $214 to $4,571Professionalmedian $316 · 10th to 90th $155 to $513
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 $257.04 Median $5,623.41 Typical High $8,709.64 | Facility | None | $257.04 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $251.19 | Professional | None | $151.36 | $208.93 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $2,398.83 Typical High $3,162.28 | Facility | None | $870.96 | $2,398.83 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $501.19 | Professional | None | $239.88 | $323.59 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $416.87 | Professional | None | $295.12 | $338.84 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $467.74 Typical High $8,709.64 | Facility | None | $257.04 | $467.74 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $467.74 | Professional | None | $173.78 | $251.19 | $467.74 |
Pacific Source Setting Facility Modifier None Typical Low $204.17 Median $331.13 Typical High $363.08 | Facility | None | $204.17 | $331.13 | $363.08 |
Providence Setting Facility Modifier None Typical Low $281.84 Median $2,137.96 Typical High $3,090.30 | Facility | None | $281.84 | $2,137.96 | $3,090.30 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $323.59 Typical High $524.81 | Professional | None | $79.43 | $323.59 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $9,772.37 Typical High $11,220.18 | Facility | None | $4,570.88 | $9,772.37 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $549.54 | Professional | None | $346.74 | $371.54 | $549.54 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $630.96 | Professional | None | $263.03 | $354.81 | $630.96 |
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 $104.71 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $42.66 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $147.91 |
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· 14th of 51
$339
OK $1,349UT $155
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.