How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,585 to $8,318Professionalmedian $2,399 · 10th to 90th $1,349 to $3,631
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 $2,344.23 Median $8,912.51 Typical High $18,620.87 | Facility | None | $2,344.23 | $8,912.51 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $5,623.41 Typical High $7,762.47 | Facility | None | $870.96 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $3,715.35 | Professional | None | $1,412.54 | $2,187.76 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,290.87 | $2,691.53 | $3,311.31 |
Moda Health Setting Facility Modifier None Typical Low $2,344.23 Median $6,918.31 Typical High $18,620.87 | Facility | None | $2,344.23 | $6,918.31 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,995.26 | $3,019.95 |
Pacific Source Setting Facility Modifier None Typical Low $1,548.82 Median $2,570.40 Typical High $2,691.53 | Facility | None | $1,548.82 | $2,570.40 | $2,691.53 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $5,128.61 Typical High $7,413.10 | Facility | None | $1,023.29 | $5,128.61 | $7,413.10 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,511.89 Typical High $3,715.35 | Professional | None | $79.43 | $2,511.89 | $3,715.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,760.83 Median $16,218.10 Typical High $23,442.29 | Facility | None | $6,760.83 | $16,218.10 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,511.89 Median $2,691.53 Typical High $3,467.37 | Professional | None | $2,511.89 | $2,691.53 | $3,467.37 |
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 $1,584.89 Median $2,398.83 Typical High $3,981.07 | Professional | None | $1,584.89 | $2,398.83 | $3,981.07 |
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 $758.58 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $758.58 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $309.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,148.15 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $229.09 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $151.36 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $954.99 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $380.19 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,318.26 |
Where Oregon sits
The same service costs 15.1 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
$2,512
AK $5,370TX $355
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.