How much rates vary
Facilitymedian $1,413 · 10th to 90th $851 to $10,000Professionalmedian $1,380 · 10th to 90th $724 to $2,138
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | None | $851.14 | $851.14 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,412.54 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,288.25 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,380.38 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $24,547.09 | Facility | None | $1,202.26 | $2,041.74 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $2,137.96 | Professional | None | $851.14 | $1,122.02 | $2,137.96 |
Pacific Source Setting Facility Modifier None Typical Low $851.14 Median $1,348.96 Typical High $1,479.11 | Facility | None | $851.14 | $1,348.96 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $1,122.02 Median $5,248.07 Typical High $7,762.47 | Facility | None | $1,122.02 | $5,248.07 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,380.38 Typical High $2,137.96 | Professional | None | $79.43 | $1,380.38 | $2,137.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $19,952.62 Typical High $22,908.68 | Facility | None | $14,454.40 | $19,952.62 | $22,908.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,412.54 | $1,479.11 | $2,187.76 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,513.56 | $2,511.89 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $21,379.62 Median $30,199.52 Typical High $34,673.69 | Facility | 50 · Both sides | $21,379.62 | $30,199.52 | $34,673.69 |
Where Oregon sits
The same service costs 6.5 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· 12th of 51
$1,413
AK $3,467UT $537
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.