How much rates vary
Facilitymedian $5,248 · 10th to 90th $3,162 to $8,913Professionalmedian $5,012 · 10th to 90th $2,754 to $7,586
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 $3,548.13 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,548.13 | $3,890.45 | $3,890.45 |
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 $2,884.03 Median $4,570.88 Typical High $7,585.78 | Professional | None | $2,884.03 | $4,570.88 | $7,585.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,466.84 Median $5,248.07 Typical High $6,456.54 | Professional | None | $4,466.84 | $5,248.07 | $6,456.54 |
Moda Health Setting Facility Modifier None Typical Low $3,890.45 Median $7,079.46 Typical High $18,620.87 | Facility | None | $3,890.45 | $7,079.46 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $3,890.45 Median $4,168.69 Typical High $6,309.57 | Professional | None | $3,890.45 | $4,168.69 | $6,309.57 |
Pacific Source Setting Facility Modifier None Typical Low $3,235.94 Median $5,248.07 Typical High $5,623.41 | Facility | None | $3,235.94 | $5,248.07 | $5,623.41 |
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 $4,897.79 Typical High $7,585.78 | Professional | None | $79.43 | $4,897.79 | $7,585.78 |
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 $5,370.32 Median $5,623.41 Typical High $7,413.10 | Professional | None | $5,370.32 | $5,623.41 | $7,413.10 |
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 $3,467.37 Median $5,011.87 Typical High $8,317.64 | Professional | None | $3,467.37 | $5,011.87 | $8,317.64 |
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 $1,621.81 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,621.81 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $645.65 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,398.83 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $489.78 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $323.59 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,754.23 | $2,754.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $776.25 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,951.21 | $2,951.21 | $2,951.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,754.23 | $2,754.23 | $2,754.23 |
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
$5,248
AK $11,220TX $537
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.