How much rates vary
Facilitymedian $1,585 · 10th to 90th $912 to $6,026Professionalmedian $1,445 · 10th to 90th $589 to $2,455
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,235.94 Typical High $4,466.84 | Facility | None | $891.25 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,445.44 Typical High $2,454.71 | Professional | None | $588.84 | $1,445.44 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,659.59 Typical High $1,949.84 | Professional | None | $758.58 | $1,659.59 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,089.30 Typical High $8,709.64 | Facility | None | $1,202.26 | $2,089.30 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,318.26 | $2,691.53 |
Pacific Source Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $1,698.24 | Facility | None | $912.01 | $1,412.54 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $2,951.21 Typical High $4,466.84 | Facility | None | $912.01 | $2,951.21 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,380.38 Typical High $2,398.83 | Professional | None | $79.43 | $1,380.38 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $13,182.57 Typical High $15,135.61 | Facility | None | $9,332.54 | $13,182.57 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,621.81 | $1,737.80 | $2,137.96 |
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 $1,096.48 Median $1,479.11 Typical High $2,818.38 | Professional | None | $1,096.48 | $1,479.11 | $2,818.38 |
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 $562.34 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $562.34 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $223.87 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $851.14 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $169.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $112.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $933.25 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,803.84 Median $19,952.62 Typical High $22,387.21 | Facility | 50 · Both sides | $13,803.84 | $19,952.62 | $22,387.21 |
Where Oregon sits
The same service costs 8.3 times more in Wyoming 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· 16th of 51
$1,514
WY $4,074UT $490
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.