How much rates vary
Facilitymedian $977 · 10th to 90th $589 to $7,943Professionalmedian $871 · 10th to 90th $398 to $1,413
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | None | $758.58 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $3,311.31 Typical High $4,466.84 | Facility | None | $1,412.54 | $3,311.31 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $831.76 Typical High $1,412.54 | Professional | None | $398.11 | $831.76 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $912.01 Typical High $1,071.52 | Professional | None | $416.87 | $912.01 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $851.14 Median $1,230.27 Typical High $24,547.09 | Facility | None | $851.14 | $1,230.27 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,584.89 | Professional | None | $707.95 | $776.25 | $1,584.89 |
Pacific Source Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $1,000.00 | Facility | None | $575.44 | $933.25 | $1,000.00 |
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 $851.14 Typical High $1,412.54 | Professional | None | $79.43 | $851.14 | $1,412.54 |
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 $933.25 Median $1,000.00 Typical High $1,230.27 | Professional | None | $933.25 | $1,000.00 | $1,230.27 |
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 $676.08 Median $933.25 Typical High $1,621.81 | Professional | None | $676.08 | $933.25 | $1,621.81 |
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 $316.23 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $316.23 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $478.63 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $63.10 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $446.68 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $380.19 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $151.36 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $562.34 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $114.82 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $75.86 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $524.81 | $537.03 | $537.03 |
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 7.9 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· 13th of 51
$955
WY $2,399UT $302
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.