How much rates vary
Facilitymedian $1,259 · 10th to 90th $851 to $8,913Professionalmedian $1,122 · 10th to 90th $513 to $1,820
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 $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | None | $977.24 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $4,466.84 | Facility | None | $1,230.27 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,071.52 Typical High $1,819.70 | Professional | None | $512.86 | $1,071.52 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $1,174.90 Typical High $1,380.38 | Professional | None | $549.54 | $1,174.90 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $18,620.87 | Facility | None | $1,023.29 | $1,819.70 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $2,041.74 | Professional | None | $912.01 | $1,000.00 | $2,041.74 |
Pacific Source Setting Facility Modifier None Typical Low $741.31 Median $1,230.27 Typical High $1,288.25 | Facility | None | $741.31 | $1,230.27 | $1,288.25 |
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 $1,122.02 Typical High $1,819.70 | Professional | None | $79.43 | $1,122.02 | $1,819.70 |
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 $1,202.26 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,288.25 | $1,584.89 |
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 $870.96 Median $1,202.26 Typical High $2,089.30 | Professional | None | $870.96 | $1,202.26 | $2,089.30 |
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 $407.38 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $489.78 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $194.98 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $724.44 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $691.83 |
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 8.5 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· 13th of 51
$1,230
WY $3,020UT $355
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.