How much rates vary
Facilitymedian $1,698 · 10th to 90th $1,000 to $8,318Professionalmedian $1,549 · 10th to 90th $631 to $2,630
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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,235.94 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,548.82 Typical High $2,630.27 | Professional | None | $630.96 | $1,548.82 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,778.28 Typical High $2,089.30 | Professional | None | $812.83 | $1,778.28 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $17,378.01 | Facility | None | $1,288.25 | $2,187.76 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,412.54 | $2,884.03 |
Pacific Source Setting Facility Modifier None Typical Low $977.24 Median $1,548.82 Typical High $1,819.70 | Facility | None | $977.24 | $1,548.82 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $2,951.21 Typical High $4,466.84 | Facility | None | $1,023.29 | $2,951.21 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,479.11 Typical High $2,570.40 | Professional | None | $79.43 | $1,479.11 | $2,570.40 |
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 $1,737.80 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,737.80 | $1,862.09 | $2,290.87 |
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 $1,174.90 Median $1,584.89 Typical High $3,019.95 | Professional | None | $1,174.90 | $1,584.89 | $3,019.95 |
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 $602.56 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $281.84 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,047.13 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $977.24 | $1,000.00 | $1,000.00 |
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 8.1 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
$1,660
WY $4,169UT $513
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.