How much rates vary
Facilitymedian $4,169 · 10th to 90th $2,512 to $7,762Professionalmedian $3,981 · 10th to 90th $2,239 to $6,026
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,691.53 | $3,162.28 | $3,162.28 |
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 $2,344.23 Median $3,715.35 Typical High $6,165.95 | Professional | None | $2,344.23 | $3,715.35 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $5,495.41 | Professional | None | $3,801.89 | $4,466.84 | $5,495.41 |
Moda Health Setting Facility Modifier None Typical Low $2,570.40 Median $4,570.88 Typical High $7,943.28 | Facility | None | $2,570.40 | $4,570.88 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,162.28 Typical High $4,786.30 | Professional | None | $3,090.30 | $3,162.28 | $4,786.30 |
Pacific Source Setting Facility Modifier None Typical Low $2,630.27 Median $3,801.89 Typical High $4,466.84 | Facility | None | $2,630.27 | $3,801.89 | $4,466.84 |
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 $3,801.89 Typical High $6,165.95 | Professional | None | $79.43 | $3,801.89 | $6,165.95 |
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 $4,265.80 Median $4,466.84 Typical High $5,754.40 | Professional | None | $4,265.80 | $4,466.84 | $5,754.40 |
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 $2,630.27 Median $3,981.07 Typical High $6,606.93 | Professional | None | $2,630.27 | $3,981.07 | $6,606.93 |
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 $1,288.25 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,288.25 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $512.86 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,905.46 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $380.19 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $257.04 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $645.65 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $2,238.72 |
Where Oregon sits
The same service costs 21.4 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· 10th of 51
$3,981
AK $9,120TX $427
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.