How much rates vary
Facilitymedian $562 · 10th to 90th $331 to $5,012Professionalmedian $537 · 10th to 90th $288 to $851
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 $288.40 Median $338.84 Typical High $338.84 | Professional | None | $288.40 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,235.94 Typical High $4,466.84 | Facility | None | $870.96 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $794.33 | Professional | None | $389.05 | $512.86 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $660.69 | Professional | None | $467.74 | $549.54 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $776.25 Typical High $7,943.28 | Facility | None | $446.68 | $776.25 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $776.25 | Professional | None | $338.84 | $426.58 | $776.25 |
Pacific Source Setting Facility Modifier None Typical Low $331.13 Median $524.81 Typical High $588.84 | Facility | None | $331.13 | $524.81 | $588.84 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $2,951.21 Typical High $4,265.80 | Facility | None | $446.68 | $2,951.21 | $4,265.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $851.14 | Professional | None | $79.43 | $524.81 | $851.14 |
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 $562.34 Median $588.84 Typical High $870.96 | Professional | None | $562.34 | $588.84 | $870.96 |
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 $426.58 Median $575.44 Typical High $1,000.00 | Professional | None | $426.58 | $575.44 | $1,000.00 |
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 $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $251.19 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $234.42 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $11,220.18 Median $15,848.93 Typical High $18,620.87 | Facility | 50 · Both sides | $11,220.18 | $15,848.93 | $18,620.87 |
Where Oregon sits
The same service costs 6.0 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· 15th of 51
$562
OK $1,479UT $245
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.