How much rates vary
Facilitymedian $2,042 · 10th to 90th $1,230 to $6,918Professionalmedian $1,862 · 10th to 90th $832 to $3,020
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 $1,659.59 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,659.59 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,398.83 Typical High $3,235.94 | Facility | None | $1,000.00 | $2,398.83 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,778.28 Typical High $3,090.30 | Professional | None | $831.76 | $1,778.28 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,995.26 Typical High $2,344.23 | Professional | None | $912.01 | $1,995.26 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,698.24 Median $2,818.38 Typical High $17,378.01 | Facility | None | $1,698.24 | $2,818.38 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,698.24 | $3,388.44 |
Pacific Source Setting Facility Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,137.96 | Facility | None | $1,230.27 | $1,995.26 | $2,137.96 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $2,344.23 Typical High $3,235.94 | Facility | None | $1,000.00 | $2,344.23 | $3,235.94 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,778.28 Typical High $3,019.95 | Professional | None | $79.43 | $1,778.28 | $3,019.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,128.31 Typical High $9,332.54 | Facility | None | $6,025.60 | $8,128.31 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $2,630.27 | Professional | None | $2,041.74 | $2,187.76 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,445.44 | $1,995.26 | $3,467.37 |
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 $691.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $691.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $831.76 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $331.13 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $1,174.90 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $9,120.11 Median $12,022.64 Typical High $13,803.84 | Facility | 50 · Both sides | $9,120.11 | $12,022.64 | $13,803.84 |
Where Oregon sits
The same service costs 7.6 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· 9th of 51
$1,995
AK $4,365UT $575
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.