How much rates vary
Facilitymedian $1,288 · 10th to 90th $776 to $4,786Professionalmedian $1,288 · 10th to 90th $617 to $1,950
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 $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | None | $794.33 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,698.24 | Facility | None | $831.76 | $1,258.93 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,862.09 | Professional | None | $933.25 | $1,202.26 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,288.25 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,949.84 Typical High $17,378.01 | Facility | None | $1,000.00 | $1,949.84 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,778.28 | Professional | None | $977.24 | $1,047.13 | $1,778.28 |
Pacific Source Setting Facility Modifier None Typical Low $776.25 Median $1,230.27 Typical High $1,348.96 | Facility | None | $776.25 | $1,230.27 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $1,288.25 Typical High $1,949.84 | Facility | None | $831.76 | $1,288.25 | $1,949.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,258.93 Typical High $1,949.84 | Professional | None | $79.43 | $1,258.93 | $1,949.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $6,025.60 | Facility | None | $3,801.89 | $5,248.07 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,348.96 | $1,995.26 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,290.87 | Professional | None | $977.24 | $1,445.44 | $2,290.87 |
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 $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $588.84 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $549.54 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $5,754.40 Median $7,762.47 Typical High $9,120.11 | Facility | 50 · Both sides | $5,754.40 | $7,762.47 | $9,120.11 |
Where Oregon sits
The same service costs 5.9 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
$1,288
AK $2,692UT $457
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.