How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,148 to $7,943Professionalmedian $1,950 · 10th to 90th $1,072 to $3,236
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $23,988.33 | Facility | None | $549.54 | $1,000.00 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,398.83 Typical High $2,951.21 | Professional | None | $1,905.46 | $2,398.83 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $1,737.80 Median $3,019.95 Typical High $7,943.28 | Facility | None | $1,737.80 | $3,019.95 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,584.89 | $1,862.09 | $2,884.03 |
Pacific Source Setting Facility Modifier None Typical Low $1,348.96 Median $2,187.76 Typical High $2,511.89 | Facility | None | $1,348.96 | $2,187.76 | $2,511.89 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,047.13 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,071.52 Typical High $3,630.78 | Professional | None | $79.43 | $1,071.52 | $3,630.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,309.57 | $6,309.57 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,995.26 | $2,137.96 | $3,162.28 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,089.30 | $3,630.78 |
8 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 54 · Surgery only Typical Low $812.83 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $812.83 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $162.18 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $758.58 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $851.14 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $169.82 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $112.20 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $794.33 | $1,096.48 | $1,096.48 |
Where Oregon sits
The same service costs 16.2 times more in Alaska than in Texas. 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· 8th of 51
$1,995
AK $3,090TX $191
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.