How much rates vary
Facilitymedian $1,585 · 10th to 90th $955 to $15,849Professionalmedian $1,549 · 10th to 90th $832 to $2,399
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 $812.83 Median $954.99 Typical High $1,071.52 | Professional | None | $812.83 | $954.99 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $9,772.37 Typical High $13,182.57 | Facility | None | $1,000.00 | $9,772.37 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,445.44 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,548.82 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $24,547.09 | Facility | None | $1,047.13 | $7,943.28 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $2,398.83 | Professional | None | $954.99 | $1,202.26 | $2,398.83 |
Pacific Source Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $1,659.59 | Facility | None | $954.99 | $1,548.82 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $9,120.11 Typical High $12,589.25 | Facility | None | $870.96 | $9,120.11 | $12,589.25 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,584.89 Typical High $2,398.83 | Professional | None | $79.43 | $1,584.89 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $25,118.86 Median $35,481.34 Typical High $40,738.03 | Facility | None | $25,118.86 | $35,481.34 | $40,738.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,548.82 | $1,659.59 | $2,454.71 |
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 $1,202.26 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,698.24 | $2,818.38 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Where Oregon sits
The same service costs 11.0 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· 12th of 51
$1,585
OK $5,888UT $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.