How much rates vary
Facilitymedian $2,042 · 10th to 90th $1,288 to $8,318Professionalmedian $1,905 · 10th to 90th $1,023 to $2,754
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,513.56 | $1,513.56 |
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 $1,174.90 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,659.59 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,737.80 | $2,041.74 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $3,235.94 Typical High $17,378.01 | Facility | None | $1,513.56 | $3,235.94 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,621.81 | $2,570.40 |
Pacific Source Setting Facility Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $2,238.72 | Facility | None | $1,288.25 | $1,995.26 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $5,128.61 Typical High $7,244.36 | Facility | None | $1,047.13 | $5,128.61 | $7,244.36 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,949.84 Typical High $2,884.03 | Professional | None | $79.43 | $1,949.84 | $2,884.03 |
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 $1,905.46 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,041.74 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,995.26 | $3,235.94 |
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 $588.84 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $588.84 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $234.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $891.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $177.83 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $117.49 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $831.76 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,071.52 |
Where Oregon sits
The same service costs 7.9 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· 9th of 51
$1,950
AK $4,074TX $513
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.