How much rates vary
Facilitymedian $1,380 · 10th to 90th $912 to $7,943Professionalmedian $1,288 · 10th to 90th $724 to $1,950
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | None | $912.01 | $1,000.00 | $1,000.00 |
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 $741.31 Median $1,174.90 Typical High $1,949.84 | Professional | None | $741.31 | $1,174.90 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,445.44 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $7,943.28 | Facility | None | $1,096.48 | $1,659.59 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,096.48 | $1,584.89 |
Pacific Source Setting Facility Modifier None Typical Low $812.83 Median $1,288.25 Typical High $1,412.54 | Facility | None | $812.83 | $1,288.25 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $977.24 Median $6,165.95 Typical High $8,912.51 | Facility | None | $977.24 | $6,165.95 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,288.25 Typical High $1,949.84 | Professional | None | $79.43 | $1,288.25 | $1,949.84 |
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 $1,348.96 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,445.44 | $1,862.09 |
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 $912.01 Median $1,258.93 Typical High $2,089.30 | Professional | None | $912.01 | $1,258.93 | $2,089.30 |
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 $407.38 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $562.34 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Where Oregon sits
The same service costs 8.7 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· 11th of 51
$1,349
AK $2,884TX $331
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.