How much rates vary
Facilitymedian $1,202 · 10th to 90th $708 to $3,981Professionalmedian $1,096 · 10th to 90th $490 to $1,738
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 $933.25 Median $954.99 Typical High $954.99 | Professional | None | $933.25 | $954.99 | $954.99 |
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 $489.78 Median $1,047.13 Typical High $1,778.28 | Professional | None | $489.78 | $1,047.13 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $1,148.15 Typical High $1,348.96 | Professional | None | $524.81 | $1,148.15 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $1,778.28 Typical High $18,620.87 | Facility | None | $954.99 | $1,778.28 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,995.26 | Professional | None | $831.76 | $954.99 | $1,995.26 |
Pacific Source Setting Facility Modifier None Typical Low $724.44 Median $1,202.26 Typical High $1,258.93 | Facility | None | $724.44 | $1,202.26 | $1,258.93 |
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 $1,047.13 Typical High $1,737.80 | Professional | None | $79.43 | $1,047.13 | $1,737.80 |
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 $1,174.90 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,258.93 | $1,548.82 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,995.26 | Professional | None | $831.76 | $1,174.90 | $1,995.26 |
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 $398.11 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $398.11 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $158.49 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $588.84 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $79.43 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $549.54 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $467.74 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $190.55 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $707.95 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $93.33 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $676.08 |
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 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· 7th of 51
$1,175
AK $2,512UT $331
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.