How much rates vary
Facilitymedian $813 · 10th to 90th $490 to $7,413Professionalmedian $776 · 10th to 90th $407 to $1,230
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $602.56 | Professional | None | $426.58 | $501.19 | $602.56 |
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 $562.34 Median $758.58 Typical High $1,202.26 | Professional | None | $562.34 | $758.58 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,000.00 | Professional | None | $707.95 | $812.83 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,122.02 Typical High $17,378.01 | Facility | None | $588.84 | $1,122.02 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,122.02 | Professional | None | $446.68 | $630.96 | $1,122.02 |
Pacific Source Setting Facility Modifier None Typical Low $478.63 Median $776.25 Typical High $870.96 | Facility | None | $478.63 | $776.25 | $870.96 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $2,951.21 Typical High $4,265.80 | Facility | None | $676.08 | $2,951.21 | $4,265.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $758.58 Typical High $1,258.93 | Professional | None | $79.43 | $758.58 | $1,258.93 |
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 $831.76 Median $870.96 Typical High $1,288.25 | Professional | None | $831.76 | $870.96 | $1,288.25 |
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 $616.60 Median $851.14 Typical High $1,479.11 | Professional | None | $616.60 | $851.14 | $1,479.11 |
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 $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $346.74 |
Where Oregon sits
The same service costs 10.2 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· 14th of 51
$813
OK $2,951UT $288
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.