How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,380 to $7,943Professionalmedian $2,188 · 10th to 90th $1,148 to $3,162
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,000.00 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,905.46 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,290.87 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,949.84 | $3,388.44 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,698.24 | $1,778.28 | $2,691.53 |
Pacific Source Setting Facility Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $2,344.23 | Facility | None | $1,380.38 | $2,238.72 | $2,344.23 |
Providence Setting Facility Modifier None Typical Low $1,071.52 Median $5,248.07 Typical High $7,762.47 | Facility | None | $1,071.52 | $5,248.07 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,187.76 Typical High $3,162.28 | Professional | None | $79.43 | $2,187.76 | $3,162.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $20,417.38 Typical High $23,442.29 | Facility | None | $14,454.40 | $20,417.38 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,290.87 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,479.11 | $2,137.96 | $3,548.13 |
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 $660.69 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $660.69 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $263.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,000.00 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $199.53 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $131.83 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $933.25 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $338.84 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,174.90 |
Where Oregon sits
The same service costs 16.6 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· 10th of 51
$2,188
AK $4,677TX $282
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.