How much rates vary
Facilitymedian $3,802 · 10th to 90th $2,291 to $21,380Professionalmedian $3,631 · 10th to 90th $1,950 to $5,248
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 $15,488.17 Typical High $33,884.42 | Facility | None | $5,128.61 | $15,488.17 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,454.71 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $17,782.79 Typical High $24,547.09 | Facility | None | $870.96 | $17,782.79 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $3,162.28 Typical High $5,248.07 | Professional | None | $1,995.26 | $3,162.28 | $5,248.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $5,128.61 | Professional | None | $3,548.13 | $4,168.69 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $2,884.03 Median $5,370.32 Typical High $33,884.42 | Facility | None | $2,884.03 | $5,370.32 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $4,466.84 | Professional | None | $2,630.27 | $3,090.30 | $4,466.84 |
Pacific Source Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $3,981.07 | Facility | None | $2,290.87 | $3,630.78 | $3,981.07 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $15,848.93 Typical High $22,908.68 | Facility | None | $1,023.29 | $15,848.93 | $22,908.68 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,630.78 Typical High $5,370.32 | Professional | None | $79.43 | $3,630.78 | $5,370.32 |
Regence BlueShield Setting Facility Modifier None Typical Low $16,595.87 Median $42,657.95 Typical High $67,608.30 | Facility | None | $16,595.87 | $42,657.95 | $67,608.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,801.89 Median $3,981.07 Typical High $5,248.07 | Professional | None | $3,801.89 | $3,981.07 | $5,248.07 |
United Setting Facility Modifier None Typical Low $2,951.21 Median $6,918.31 Typical High $50,118.72 | Facility | None | $2,951.21 | $6,918.31 | $50,118.72 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $5,888.44 | Professional | None | $2,238.72 | $3,548.13 | $5,888.44 |
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 $1,122.02 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,122.02 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $446.68 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,659.59 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $331.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $223.87 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $524.81 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $1,995.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $1,862.09 |
Where Oregon sits
The same service costs 16.2 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· 9th of 51
$3,715
AK $8,128TX $501
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.