How much rates vary
Facilitymedian $1,122 · 10th to 90th $759 to $6,310Professionalmedian $977 · 10th to 90th $437 to $1,622
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 $870.96 Median $891.25 Typical High $891.25 | Professional | None | $870.96 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,089.30 Typical High $2,754.23 | Facility | None | $1,202.26 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $954.99 Typical High $1,621.81 | Professional | None | $436.52 | $954.99 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $1,071.52 Typical High $1,258.93 | Professional | None | $489.78 | $1,071.52 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,479.11 Typical High $18,620.87 | Facility | None | $891.25 | $1,479.11 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,819.70 | Professional | None | $776.25 | $891.25 | $1,819.70 |
Pacific Source Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,148.15 | Facility | None | $645.65 | $1,047.13 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $1,905.46 Typical High $2,951.21 | Facility | None | $1,000.00 | $1,905.46 | $2,951.21 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $954.99 Typical High $1,621.81 | Professional | None | $79.43 | $954.99 | $1,621.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $8,128.31 Typical High $9,332.54 | Facility | None | $5,754.40 | $8,128.31 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,148.15 | $1,412.54 |
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 $758.58 Median $1,023.29 Typical High $1,862.09 | Professional | None | $758.58 | $1,023.29 | $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 $363.08 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $436.52 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $645.65 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $616.60 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,709.64 Median $12,302.69 Typical High $13,803.84 | Facility | 50 · Both sides | $8,709.64 | $12,302.69 | $13,803.84 |
Where Oregon sits
The same service costs 8.5 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· 11th of 51
$1,072
WY $2,512UT $295
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.