How much rates vary
Facilitymedian $646 · 10th to 90th $389 to $6,918Professionalmedian $617 · 10th to 90th $331 to $977
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 $354.81 Median $389.05 Typical High $478.63 | Professional | None | $354.81 | $389.05 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $23,988.33 | Facility | None | $549.54 | $1,000.00 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $933.25 | Professional | None | $457.09 | $602.56 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $776.25 | Professional | None | $562.34 | $645.65 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $912.01 Typical High $8,709.64 | Facility | None | $512.86 | $912.01 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $977.24 | Professional | None | $363.08 | $501.19 | $977.24 |
Pacific Source Setting Facility Modifier None Typical Low $389.05 Median $630.96 Typical High $676.08 | Facility | None | $389.05 | $630.96 | $676.08 |
Providence Setting Facility Modifier None Typical Low $524.81 Median $251,188.64 Typical High $251,188.64 | Facility | None | $524.81 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $616.60 Typical High $977.24 | Professional | None | $79.43 | $616.60 | $977.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $1,023.29 | Professional | None | $645.65 | $691.83 | $1,023.29 |
United Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $6,918.31 | Facility | None | $602.56 | $954.99 | $6,918.31 |
United Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $1,174.90 | Professional | None | $489.78 | $676.08 | $1,174.90 |
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 $194.98 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $194.98 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $295.12 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $275.42 |
Where Oregon sits
The same service costs 5.8 times more in Alaska 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· 10th of 51
$646
AK $1,380UT $240
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.