How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,905 to $10,715Professionalmedian $2,951 · 10th to 90th $1,622 to $4,467
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 $2,089.30 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,089.30 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $7,079.46 Typical High $9,772.37 | Facility | None | $870.96 | $7,079.46 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $4,466.84 | Professional | None | $1,698.24 | $2,691.53 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,691.53 Median $3,162.28 Typical High $3,801.89 | Professional | None | $2,691.53 | $3,162.28 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $2,290.87 Median $4,570.88 Typical High $18,620.87 | Facility | None | $2,290.87 | $4,570.88 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $3,715.35 | Professional | None | $2,290.87 | $2,454.71 | $3,715.35 |
Pacific Source Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $3,388.44 | Facility | None | $1,905.46 | $3,162.28 | $3,388.44 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $6,456.54 Typical High $9,332.54 | Facility | None | $1,023.29 | $6,456.54 | $9,332.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,951.21 Typical High $4,570.88 | Professional | None | $79.43 | $2,951.21 | $4,570.88 |
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 $3,162.28 Median $3,311.31 Typical High $4,365.16 | Professional | None | $3,162.28 | $3,311.31 | $4,365.16 |
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 $2,089.30 Median $2,951.21 Typical High $4,897.79 | Professional | None | $2,089.30 | $2,951.21 | $4,897.79 |
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 $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $954.99 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $380.19 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,412.54 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $281.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $190.55 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $457.09 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,621.81 |
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
$3,090
AK $6,607TX $324
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.