How much rates vary
Facilitymedian $3,388 · 10th to 90th $2,042 to $9,120Professionalmedian $3,090 · 10th to 90th $1,738 to $4,786
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 $2,137.96 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,137.96 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $6,918.31 Typical High $9,549.93 | Facility | None | $870.96 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $4,786.30 | Professional | None | $1,819.70 | $2,818.38 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $4,677.35 | Professional | None | $3,235.94 | $3,801.89 | $4,677.35 |
Moda Health Setting Facility Modifier None Typical Low $2,630.27 Median $4,265.80 Typical High $24,547.09 | Facility | None | $2,630.27 | $4,265.80 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,511.89 Typical High $4,073.80 | Professional | None | $2,344.23 | $2,511.89 | $4,073.80 |
Pacific Source Setting Facility Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $3,548.13 | Facility | None | $2,041.74 | $3,019.95 | $3,548.13 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $6,165.95 Typical High $8,912.51 | Facility | None | $1,023.29 | $6,165.95 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,951.21 Typical High $4,786.30 | Professional | None | $79.43 | $2,951.21 | $4,786.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,943.28 Median $21,379.62 Typical High $29,512.09 | Facility | None | $7,943.28 | $21,379.62 | $29,512.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,467.37 Median $3,630.78 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,630.78 | $4,677.35 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $5,128.61 | Professional | None | $1,995.26 | $3,090.30 | $5,128.61 |
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 $1,000.00 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,000.00 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $398.11 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,479.11 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $199.53 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $467.74 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,659.59 |
Where Oregon sits
The same service costs 11.2 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
$3,162
AK $7,244TX $646
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.