How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,259 to $8,710Professionalmedian $2,042 · 10th to 90th $1,096 to $2,951
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,380.38 | $1,513.56 | $1,513.56 |
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 $1,174.90 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,174.90 | $1,778.28 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,778.28 | $2,089.30 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $1,778.28 Median $3,019.95 Typical High $24,547.09 | Facility | None | $1,778.28 | $3,019.95 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,513.56 | $1,698.24 | $2,630.27 |
Pacific Source Setting Facility Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $2,344.23 | Facility | None | $1,258.93 | $2,041.74 | $2,344.23 |
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 $1,995.26 Typical High $3,019.95 | Professional | None | $79.43 | $1,995.26 | $3,019.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $17,378.01 Typical High $23,988.33 | Facility | None | $6,165.95 | $17,378.01 | $23,988.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,187.76 | $2,884.03 |
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 $1,412.54 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,412.54 | $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 $630.96 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $630.96 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $251.19 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $891.25 | $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 17.8 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
$2,089
AK $4,467TX $251
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.