How much rates vary
Facilitymedian $7,586 · 10th to 90th $4,571 to $26,915Professionalmedian $7,244 · 10th to 90th $3,890 to $10,471
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 $4,897.79 Median $5,495.41 Typical High $5,495.41 | Professional | None | $4,897.79 | $5,495.41 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $25,703.96 Typical High $35,481.34 | Facility | None | $870.96 | $25,703.96 | $35,481.34 |
Cigna Setting Professional Modifier None Typical Low $3,981.07 Median $6,309.57 Typical High $10,715.19 | Professional | None | $3,981.07 | $6,309.57 | $10,715.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,456.54 Median $7,585.78 Typical High $9,332.54 | Professional | None | $6,456.54 | $7,585.78 | $9,332.54 |
Moda Health Setting Facility Modifier None Typical Low $6,025.60 Median $7,943.28 Typical High $10,964.78 | Facility | None | $6,025.60 | $7,943.28 | $10,964.78 |
Moda Health Setting Professional Modifier None Typical Low $5,495.41 Median $6,025.60 Typical High $8,709.64 | Professional | None | $5,495.41 | $6,025.60 | $8,709.64 |
Pacific Source Setting Facility Modifier None Typical Low $4,570.88 Median $7,585.78 Typical High $7,943.28 | Facility | None | $4,570.88 | $7,585.78 | $7,943.28 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $23,442.29 Typical High $33,884.42 | Facility | None | $1,023.29 | $23,442.29 | $33,884.42 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $7,244.36 Typical High $10,715.19 | Professional | None | $79.43 | $7,244.36 | $10,715.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $20,417.38 Median $53,703.18 Typical High $74,131.02 | Facility | None | $20,417.38 | $53,703.18 | $74,131.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $7,413.10 Median $7,943.28 Typical High $10,232.93 | Professional | None | $7,413.10 | $7,943.28 | $10,232.93 |
United Setting Facility Modifier None Typical Low $2,951.21 Median $6,918.31 Typical High $50,118.72 | Facility | None | $2,951.21 | $6,918.31 | $50,118.72 |
United Setting Professional Modifier None Typical Low $4,897.79 Median $7,244.36 Typical High $11,748.98 | Professional | None | $4,897.79 | $7,244.36 | $11,748.98 |
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 $2,238.72 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,238.72 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $1,096.48 Typical High $1,096.48 | Professional | 53 · Discontinued | $891.25 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $4,073.80 Typical High $4,073.80 | Professional | 54 · Surgery only | $3,388.44 | $4,073.80 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $812.83 Typical High $812.83 | Professional | 55 · Aftercare only | $676.08 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $446.68 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,801.89 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,801.89 | $3,801.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,754.23 | $2,754.23 | $2,754.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 53 · Discontinued | $1,096.48 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | 54 · Surgery only | $4,073.80 | $4,073.80 | $4,073.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 55 · Aftercare only | $812.83 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $549.54 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,801.89 | $3,801.89 | $3,801.89 |
Where Oregon sits
The same service costs 20.4 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
$7,413
AK $15,849TX $776
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.