How much rates vary
Facilitymedian $1,230 · 10th to 90th $741 to $3,715Professionalmedian $1,122 · 10th to 90th $631 to $1,698
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | None | $794.33 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,290.87 Typical High $3,090.30 | Facility | None | $1,000.00 | $2,290.87 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,737.80 | Professional | None | $660.69 | $1,047.13 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,348.96 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,348.96 Typical High $7,943.28 | Facility | None | $891.25 | $1,348.96 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,479.11 | Professional | None | $851.14 | $954.99 | $1,479.11 |
Pacific Source Setting Facility Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,288.25 | Facility | None | $741.31 | $1,096.48 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $3,090.30 | Facility | None | $912.01 | $2,089.30 | $3,090.30 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,122.02 Typical High $1,737.80 | Professional | None | $79.43 | $1,122.02 | $1,737.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $7,244.36 Typical High $15,488.17 | Facility | None | $5,128.61 | $7,244.36 | $15,488.17 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,288.25 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,862.09 | Professional | None | $724.44 | $1,148.15 | $1,862.09 |
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 $371.54 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $562.34 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $524.81 | $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 $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
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 $7,762.47 Median $10,964.78 Typical High $23,442.29 | Facility | 50 · Both sides | $7,762.47 | $10,964.78 | $23,442.29 |
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
$1,175
AK $2,570UT $447
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.