How much rates vary
Facilitymedian $4,169 · 10th to 90th $2,512 to $20,893Professionalmedian $3,981 · 10th to 90th $2,138 to $5,754
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 $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 $2,691.53 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,691.53 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $17,378.01 Typical High $23,442.29 | Facility | None | $870.96 | $17,378.01 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $3,467.37 Typical High $5,754.40 | Professional | None | $2,187.76 | $3,467.37 | $5,754.40 |
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 $3,311.31 Median $5,888.44 Typical High $33,884.42 | Facility | None | $3,311.31 | $5,888.44 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $4,897.79 | Professional | None | $2,951.21 | $3,311.31 | $4,897.79 |
Pacific Source Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $4,365.16 | Facility | None | $2,511.89 | $3,981.07 | $4,365.16 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $15,488.17 Typical High $22,387.21 | Facility | None | $1,023.29 | $15,488.17 | $22,387.21 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,981.07 Typical High $5,888.44 | Professional | None | $79.43 | $3,981.07 | $5,888.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,378.01 Median $53,703.18 Typical High $74,131.02 | Facility | None | $17,378.01 | $53,703.18 | $74,131.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,073.80 Median $4,365.16 Typical High $5,623.41 | Professional | None | $4,073.80 | $4,365.16 | $5,623.41 |
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 $2,691.53 Median $3,981.07 Typical High $6,456.54 | Professional | None | $2,691.53 | $3,981.07 | $6,456.54 |
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 $1,230.27 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,230.27 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $489.78 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,819.70 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $371.54 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $245.47 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,479.11 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,238.72 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $295.12 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $2,089.30 |
Where Oregon sits
The same service costs 6.5 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
$4,074
AK $8,710TX $1,349
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.