How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,413 to $6,310Professionalmedian $4,677 · 10th to 90th $1,202 to $7,413
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 $2,089.30 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,089.30 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $2,187.76 Typical High $2,884.03 | Facility | None | $1,230.27 | $2,187.76 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $4,466.84 Typical High $7,413.10 | Professional | None | $3,715.35 | $4,466.84 | $7,413.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,801.89 Median $5,011.87 Typical High $5,623.41 | Professional | None | $3,801.89 | $5,011.87 | $5,623.41 |
Moda Health Setting Facility Modifier None Typical Low $3,715.35 Median $6,760.83 Typical High $18,620.87 | Facility | None | $3,715.35 | $6,760.83 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,981.07 Typical High $5,888.44 | Professional | None | $3,715.35 | $3,981.07 | $5,888.44 |
Pacific Source Setting Facility Modifier None Typical Low $3,090.30 Median $4,677.35 Typical High $5,370.32 | Facility | None | $3,090.30 | $4,677.35 | $5,370.32 |
Providence Setting Facility Modifier None Typical Low $1,258.93 Median $2,344.23 Typical High $5,888.44 | Facility | None | $1,258.93 | $2,344.23 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $4,677.35 Typical High $7,585.78 | Professional | None | $79.43 | $4,677.35 | $7,585.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $7,413.10 | Facility | None | $4,786.30 | $6,456.54 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,011.87 Median $5,370.32 Typical High $6,918.31 | Professional | None | $5,011.87 | $5,370.32 | $6,918.31 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $3,630.78 Median $4,897.79 Typical High $8,709.64 | Professional | None | $3,630.78 | $4,897.79 | $8,709.64 |
12 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 $1,071.52 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,071.52 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $436.52 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,621.81 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $323.59 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $218.78 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,630.27 | $2,630.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,047.13 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $416.87 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,584.89 | $2,818.38 | $2,818.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $316.23 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $208.93 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,479.11 | $2,630.27 | $2,630.27 |
Where Oregon sits
The same service costs 15.8 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· 7th of 51
$4,677
AK $8,128TX $513
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.