How much rates vary
Facilitymedian $1,175 · 10th to 90th $794 to $9,772Professionalmedian $1,122 · 10th to 90th $550 to $1,738
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $851.14 | Professional | None | $549.54 | $812.83 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,230.27 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,659.59 | Professional | None | $794.33 | $1,071.52 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,380.38 | Professional | None | $977.24 | $1,122.02 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $912.01 Median $1,659.59 Typical High $18,620.87 | Facility | None | $912.01 | $1,659.59 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,584.89 | Professional | None | $645.65 | $870.96 | $1,584.89 |
Pacific Source Setting Facility Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,202.26 | Facility | None | $676.08 | $1,122.02 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $954.99 Median $5,128.61 Typical High $7,762.47 | Facility | None | $954.99 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,096.48 Typical High $1,737.80 | Professional | None | $79.43 | $1,096.48 | $1,737.80 |
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 $1,148.15 Median $1,202.26 Typical High $1,778.28 | Professional | None | $1,148.15 | $1,202.26 | $1,778.28 |
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 $851.14 Median $1,230.27 Typical High $2,089.30 | Professional | None | $851.14 | $1,230.27 | $2,089.30 |
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 $354.81 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $354.81 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $141.25 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $70.79 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $575.44 |
Where Oregon sits
The same service costs 8.1 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
$1,148
OK $3,467UT $427
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.