How much rates vary
Facilitymedian $5,248 · 10th to 90th $3,236 to $11,749Professionalmedian $4,898 · 10th to 90th $2,818 to $7,586
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 $3,235.94 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,235.94 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $6,918.31 Typical High $9,549.93 | Facility | None | $1,258.93 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $4,570.88 Typical High $7,762.47 | Professional | None | $2,951.21 | $4,570.88 | $7,762.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,786.30 Median $5,495.41 Typical High $6,760.83 | Professional | None | $4,786.30 | $5,495.41 | $6,760.83 |
Moda Health Setting Facility Modifier None Typical Low $3,981.07 Median $5,888.44 Typical High $18,620.87 | Facility | None | $3,981.07 | $5,888.44 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $6,309.57 | Professional | None | $3,981.07 | $3,981.07 | $6,309.57 |
Pacific Source Setting Facility Modifier None Typical Low $3,235.94 Median $4,677.35 Typical High $5,623.41 | Facility | None | $3,235.94 | $4,677.35 | $5,623.41 |
Providence Setting Facility Modifier None Typical Low $1,348.96 Median $6,456.54 Typical High $9,549.93 | Facility | None | $1,348.96 | $6,456.54 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $4,677.35 Typical High $7,762.47 | Professional | None | $79.43 | $4,677.35 | $7,762.47 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,782.79 Median $25,118.86 Typical High $28,183.83 | Facility | None | $17,782.79 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,370.32 Median $5,754.40 Typical High $7,244.36 | Professional | None | $5,370.32 | $5,754.40 | $7,244.36 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $8,128.31 | Professional | None | $3,235.94 | $5,011.87 | $8,128.31 |
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 $1,621.81 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,621.81 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,398.83 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $489.78 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $323.59 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,754.23 | $2,754.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $794.33 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,951.21 | $2,951.21 | $2,951.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,754.23 | $2,754.23 | $2,754.23 |
Where Oregon sits
The same service costs 19.5 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· 9th of 51
$5,012
AK $11,482TX $589
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.