How much rates vary
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,025.60 Typical High $8,317.64 | Facility | None | $1,000.00 | $6,025.60 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,380.38 | Professional | None | $660.69 | $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 $660.69 Median $1,230.27 Typical High $17,378.01 | Facility | None | $660.69 | $1,230.27 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,288.25 | Professional | None | $575.44 | $741.31 | $1,288.25 |
Pacific Source Setting Facility Modifier None Typical Low $562.34 Median $891.25 Typical High $1,000.00 | Facility | None | $562.34 | $891.25 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $5,623.41 Typical High $8,317.64 | Facility | None | $794.33 | $5,623.41 | $8,317.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $891.25 Typical High $1,445.44 | Professional | None | $79.43 | $891.25 | $1,445.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,952.62 Median $26,302.68 Typical High $30,199.52 | Facility | None | $19,952.62 | $26,302.68 | $30,199.52 |
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 $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,698.24 | Professional | None | $707.95 | $977.24 | $1,698.24 |
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 $288.40 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
Where Oregon sits
The same service costs 11.2 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· 12th of 51
$933
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.