How much rates vary
Facilitymedian $1,950 · 10th to 90th $1,175 to $8,710Professionalmedian $1,778 · 10th to 90th $724 to $2,818
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 $812.83 Median $1,412.54 Typical High $1,412.54 | Professional | None | $812.83 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $3,630.78 Typical High $5,011.87 | Facility | None | $1,230.27 | $3,630.78 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,412.54 | $1,698.24 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,949.84 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,818.38 Typical High $18,620.87 | Facility | None | $1,412.54 | $2,818.38 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,513.56 | $2,290.87 |
Pacific Source Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $2,041.74 | Facility | None | $1,148.15 | $1,905.46 | $2,041.74 |
Providence Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $5,011.87 | Facility | None | $1,258.93 | $3,311.31 | $5,011.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,778.28 Typical High $2,818.38 | Professional | None | $79.43 | $1,778.28 | $2,818.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,912.51 Median $12,589.25 Typical High $14,454.40 | Facility | None | $8,912.51 | $12,589.25 | $14,454.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,862.09 | $2,041.74 | $2,570.40 |
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 $1,348.96 Median $1,819.70 Typical High $3,311.31 | Professional | None | $1,348.96 | $1,819.70 | $3,311.31 |
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 $389.05 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $389.05 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $154.88 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $588.84 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $117.49 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $77.62 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $549.54 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $389.05 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $154.88 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $575.44 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $114.82 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $77.62 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $537.03 | $977.24 | $977.24 |
Where Oregon sits
The same service costs 8.3 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
$1,905
AK $4,074TX $490
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.