How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,288 to $20,893Professionalmedian $1,862 · 10th to 90th $79 to $3,020
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
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 $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 $1,148.15 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,819.70 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,884.03 | Professional | None | $1,995.26 | $2,344.23 | $2,884.03 |
Moda Health Setting Facility Modifier None Typical Low $1,659.59 Median $7,943.28 Typical High $18,620.87 | Facility | None | $1,659.59 | $7,943.28 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Pacific Source Setting Facility Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $2,187.76 | Facility | None | $1,288.25 | $2,041.74 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $16,595.87 Typical High $22,908.68 | Facility | None | $1,000.00 | $16,595.87 | $22,908.68 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,584.89 Typical High $3,235.94 | Professional | None | $79.43 | $1,584.89 | $3,235.94 |
Regence BlueShield Setting Facility Modifier None Typical Low $13,489.63 Median $41,686.94 Typical High $57,543.99 | Facility | None | $13,489.63 | $41,686.94 | $57,543.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,238.72 | $2,884.03 |
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 $1,288.25 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,288.25 | $1,905.46 | $3,162.28 |
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 $616.60 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $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 $933.25 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $870.96 | $1,047.13 | $1,047.13 |
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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,122.02 |
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 $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,047.13 |
Where Oregon sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 8th of 51
$2,042
AK $4,467HI $95.50
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.