How much rates vary
Facilitymedian $3,890 · 10th to 90th $2,291 to $6,607Professionalmedian $3,802 · 10th to 90th $1,905 to $5,888
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 $2,187.76 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,818.38 | $2,818.38 |
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 $2,754.23 Median $3,548.13 Typical High $5,495.41 | Professional | None | $2,754.23 | $3,548.13 | $5,495.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $3,715.35 Typical High $4,570.88 | Professional | None | $3,235.94 | $3,715.35 | $4,570.88 |
Moda Health Setting Facility Modifier None Typical Low $3,090.30 Median $4,897.79 Typical High $7,943.28 | Facility | None | $3,090.30 | $4,897.79 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,090.30 Typical High $5,248.07 | Professional | None | $2,818.38 | $3,090.30 | $5,248.07 |
Pacific Source Setting Facility Modifier None Typical Low $2,344.23 Median $3,715.35 Typical High $4,073.80 | Facility | None | $2,344.23 | $3,715.35 | $4,073.80 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,023.29 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,801.89 Typical High $5,888.44 | Professional | None | $79.43 | $3,801.89 | $5,888.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $10,471.29 | Facility | None | $10,471.29 | $10,471.29 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,801.89 Median $4,073.80 Typical High $6,025.60 | Professional | None | $3,801.89 | $4,073.80 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,467.37 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,467.37 | $22,908.68 |
United Setting Professional Modifier None Typical Low $3,019.95 Median $4,265.80 Typical High $6,918.31 | Professional | None | $3,019.95 | $4,265.80 | $6,918.31 |
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 $1,096.48 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,096.48 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $436.52 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,659.59 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $331.13 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $218.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,412.54 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $562.34 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $281.84 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $1,949.84 |
Where Oregon sits
The same service costs 8.5 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
$3,802
AK $8,128TX $955
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.