How much rates vary
Facilitymedian $912 · 10th to 90th $603 to $5,370Professionalmedian $851 · 10th to 90th $468 to $1,259
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 $602.56 Median $645.65 Typical High $645.65 | Professional | None | $602.56 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $2,454.71 | Facility | None | $891.25 | $1,819.70 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,288.25 | Professional | None | $489.78 | $776.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,174.90 | Professional | None | $812.83 | $954.99 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $1,288.25 Typical High $8,709.64 | Facility | None | $707.95 | $1,288.25 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $1,071.52 | Professional | None | $645.65 | $707.95 | $1,071.52 |
Pacific Source Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $933.25 | Facility | None | $537.03 | $870.96 | $933.25 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $1,621.81 Typical High $2,454.71 | Facility | None | $741.31 | $1,621.81 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $851.14 Typical High $1,288.25 | Professional | None | $79.43 | $851.14 | $1,288.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,918.31 Typical High $7,762.47 | Facility | None | $5,128.61 | $6,918.31 | $7,762.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,202.26 | Professional | None | $870.96 | $933.25 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,380.38 | Professional | None | $549.54 | $831.76 | $1,380.38 |
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 $269.15 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $107.15 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $407.38 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $380.19 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $457.09 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,232.93 Typical High $11,481.54 | Facility | 50 · Both sides | $7,762.47 | $10,232.93 | $11,481.54 |
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
$871
AK $1,862UT $324
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.