How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,660 to $8,318Professionalmedian $2,570 · 10th to 90th $1,413 to $3,802
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 $2,511.89 Median $8,912.51 Typical High $18,620.87 | Facility | None | $2,511.89 | $8,912.51 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,819.70 | $2,041.74 | $2,041.74 |
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 $1,479.11 Median $2,344.23 Typical High $3,890.45 | Professional | None | $1,479.11 | $2,344.23 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,467.37 | Professional | None | $2,398.83 | $2,818.38 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $2,238.72 Median $4,073.80 Typical High $18,620.87 | Facility | None | $2,238.72 | $4,073.80 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,089.30 Typical High $3,311.31 | Professional | None | $2,041.74 | $2,089.30 | $3,311.31 |
Pacific Source Setting Facility Modifier None Typical Low $1,659.59 Median $2,630.27 Typical High $2,818.38 | Facility | None | $1,659.59 | $2,630.27 | $2,818.38 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $5,128.61 Typical High $7,762.47 | Facility | None | $1,023.29 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,630.27 Typical High $3,890.45 | Professional | None | $79.43 | $2,630.27 | $3,890.45 |
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 $2,691.53 Median $2,818.38 Typical High $3,715.35 | Professional | None | $2,691.53 | $2,818.38 | $3,715.35 |
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 $1,621.81 Median $2,570.40 Typical High $4,168.69 | Professional | None | $1,621.81 | $2,570.40 | $4,168.69 |
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 $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $812.83 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $323.59 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,202.26 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $162.18 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $407.38 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Where Oregon sits
The same service costs 17.8 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
$2,692
AK $5,623TX $316
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.