How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,000 to $6,457Professionalmedian $1,950 · 10th to 90th $955 to $2,884
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,348.96 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $4,365.16 Typical High $6,025.60 | Facility | None | $1,000.00 | $4,365.16 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,122.02 | $1,778.28 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,187.76 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $2,951.21 Typical High $17,378.01 | Facility | None | $1,023.29 | $2,951.21 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,398.83 | Professional | None | $977.24 | $1,479.11 | $2,398.83 |
Pacific Source Setting Facility Modifier None Typical Low $1,122.02 Median $2,041.74 Typical High $2,137.96 | Facility | None | $1,122.02 | $2,041.74 | $2,137.96 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $3,981.07 Typical High $6,025.60 | Facility | None | $1,000.00 | $3,981.07 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,905.46 Typical High $2,951.21 | Professional | None | $79.43 | $1,905.46 | $2,951.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $11,220.18 Typical High $12,882.50 | Facility | None | $4,570.88 | $11,220.18 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,041.74 Median $2,137.96 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,137.96 | $2,818.38 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,230.27 | $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 $602.56 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $602.56 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $245.47 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $912.01 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $181.97 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $123.03 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $851.14 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $741.31 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $295.12 | $295.12 | $295.12 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
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 7.8 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· 8th of 51
$1,995
AK $4,365TX $562
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.