How much rates vary
Facilitymedian $692 · 10th to 90th $417 to $5,012Professionalmedian $631 · 10th to 90th $339 to $1,047
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 $338.84 Median $416.87 Typical High $524.81 | Professional | None | $338.84 | $416.87 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,235.94 Typical High $4,466.84 | Facility | None | $660.69 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,000.00 | Professional | None | $478.63 | $645.65 | $1,000.00 |
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 $457.09 Median $851.14 Typical High $7,943.28 | Facility | None | $457.09 | $851.14 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $933.25 | Professional | None | $416.87 | $524.81 | $933.25 |
Pacific Source Setting Facility Modifier None Typical Low $389.05 Median $602.56 Typical High $707.95 | Facility | None | $389.05 | $602.56 | $707.95 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $2,951.21 Typical High $4,466.84 | Facility | None | $537.03 | $2,951.21 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $616.60 Typical High $1,047.13 | Professional | None | $79.43 | $616.60 | $1,047.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $10,715.19 Typical High $12,589.25 | Facility | None | $7,413.10 | $10,715.19 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,071.52 | Professional | None | $691.83 | $724.44 | $1,071.52 |
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 $489.78 Median $676.08 Typical High $1,230.27 | Professional | None | $489.78 | $676.08 | $1,230.27 |
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 $199.53 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $199.53 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $79.43 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $281.84 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $208.93 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $83.18 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $309.03 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $288.40 |
Where Oregon sits
The same service costs 8.5 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
$661
OK $2,138UT $251
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.