How much rates vary
Facilitymedian $575 · 10th to 90th $398 to $6,166Professionalmedian $468 · 10th to 90th $229 to $759
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 $309.03 Median $346.74 Typical High $512.86 | Professional | None | $309.03 | $346.74 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $676.08 | Facility | None | $398.11 | $501.19 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $446.68 Typical High $870.96 | Professional | None | $208.93 | $446.68 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $776.25 | Professional | None | $346.74 | $501.19 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $13,182.57 | Facility | None | $436.52 | $707.95 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $676.08 | Professional | None | $309.03 | $501.19 | $676.08 |
Pacific Source Setting Facility Modifier None Typical Low $346.74 Median $549.54 Typical High $630.96 | Facility | None | $346.74 | $549.54 | $630.96 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $524.81 Typical High $831.76 | Facility | None | $398.11 | $524.81 | $831.76 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $446.68 Typical High $758.58 | Professional | None | $79.43 | $446.68 | $758.58 |
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 $380.19 Median $575.44 Typical High $630.96 | Professional | None | $380.19 | $575.44 | $630.96 |
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 $309.03 Median $512.86 Typical High $851.14 | Professional | None | $309.03 | $512.86 | $851.14 |
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 $154.88 Median $154.88 Typical High $257.04 | Professional | 52 · Reduced service | $154.88 | $154.88 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $102.33 | Professional | 53 · Discontinued | $61.66 | $61.66 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $389.05 | Professional | 54 · Surgery only | $229.09 | $229.09 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $77.62 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $51.29 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $177.83 Typical High $257.04 | Professional | 52 · Reduced service | $154.88 | $177.83 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $70.79 Typical High $102.33 | Professional | 53 · Discontinued | $61.66 | $70.79 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $263.03 Typical High $389.05 | Professional | 54 · Surgery only | $229.09 | $263.03 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $52.48 Typical High $77.62 | Professional | 55 · Aftercare only | $45.71 | $52.48 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $35.48 Typical High $51.29 | Professional | 56 · Pre-op care only | $30.90 | $35.48 | $51.29 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $245.47 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $213.80 | $245.47 | $363.08 |
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 4.3 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· 6th of 51
$513
WY $933UT $219
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.