How much rates vary
Facilitymedian $955 · 10th to 90th $603 to $6,310Professionalmedian $912 · 10th to 90th $447 to $1,445
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | None | $562.34 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $4,265.80 Typical High $5,888.44 | Facility | None | $891.25 | $4,265.80 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,412.54 | Professional | None | $707.95 | $912.01 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,148.15 | Professional | None | $794.33 | $933.25 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $1,230.27 Typical High $8,709.64 | Facility | None | $676.08 | $1,230.27 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,318.26 | Professional | None | $575.44 | $741.31 | $1,318.26 |
Pacific Source Setting Facility Modifier None Typical Low $549.54 Median $870.96 Typical High $1,000.00 | Facility | None | $549.54 | $870.96 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $3,981.07 Typical High $5,888.44 | Facility | None | $741.31 | $3,981.07 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $870.96 Typical High $1,445.44 | Professional | None | $79.43 | $870.96 | $1,445.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $17,378.01 Typical High $19,952.62 | Facility | None | $7,585.78 | $17,378.01 | $19,952.62 |
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 $1,230.27 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 $676.08 Median $954.99 Typical High $1,737.80 | Professional | None | $676.08 | $954.99 | $1,737.80 |
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 $281.84 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $281.84 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $112.20 | $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 $85.11 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $85.11 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $56.23 | $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 6.5 times more in Alaska than in Texas. 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· 10th of 51
$933
AK $1,995TX $309
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.