How much rates vary
Facilitymedian $5,012 · 10th to 90th $2,951 to $8,913Professionalmedian $4,786 · 10th to 90th $2,570 to $6,918
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 $3,630.78 Typical High $3,630.78 | Professional | None | $3,235.94 | $3,630.78 | $3,630.78 |
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 $2,691.53 Median $4,168.69 Typical High $7,079.46 | Professional | None | $2,691.53 | $4,168.69 | $7,079.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,168.69 Median $4,897.79 Typical High $5,888.44 | Professional | None | $4,168.69 | $4,897.79 | $5,888.44 |
Moda Health Setting Facility Modifier None Typical Low $3,630.78 Median $6,760.83 Typical High $18,620.87 | Facility | None | $3,630.78 | $6,760.83 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,890.45 Typical High $5,888.44 | Professional | None | $3,630.78 | $3,890.45 | $5,888.44 |
Pacific Source Setting Facility Modifier None Typical Low $3,019.95 Median $4,786.30 Typical High $5,248.07 | Facility | None | $3,019.95 | $4,786.30 | $5,248.07 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $6,606.93 Typical High $9,332.54 | Facility | None | $1,023.29 | $6,606.93 | $9,332.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $4,786.30 Typical High $7,079.46 | Professional | None | $79.43 | $4,786.30 | $7,079.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $17,378.01 Typical High $23,988.33 | Facility | None | $7,585.78 | $17,378.01 | $23,988.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,897.79 Median $5,248.07 Typical High $6,760.83 | Professional | None | $4,897.79 | $5,248.07 | $6,760.83 |
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 $3,311.31 Median $4,677.35 Typical High $7,585.78 | Professional | None | $3,311.31 | $4,677.35 | $7,585.78 |
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 $1,479.11 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,479.11 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $602.56 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,238.72 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $446.68 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $295.12 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,819.70 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $724.44 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $2,691.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $363.08 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $2,511.89 |
Where Oregon sits
The same service costs 20.9 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
$4,786
AK $10,471TX $501
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.