How much rates vary
Facilitymedian $1,230 · 10th to 90th $724 to $4,898Professionalmedian $1,175 · 10th to 90th $692 to $1,862
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | None | $851.14 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,090.30 Typical High $4,168.69 | Facility | None | $660.69 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,905.46 | Professional | None | $724.44 | $1,148.15 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,513.56 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $7,943.28 | Facility | None | $1,122.02 | $1,698.24 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,584.89 | Professional | None | $954.99 | $1,000.00 | $1,584.89 |
Pacific Source Setting Facility Modifier None Typical Low $741.31 Median $1,148.15 Typical High $1,380.38 | Facility | None | $741.31 | $1,148.15 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $2,754.23 Typical High $4,168.69 | Facility | None | $676.08 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,148.15 Typical High $1,905.46 | Professional | None | $79.43 | $1,148.15 | $1,905.46 |
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 $1,318.26 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,380.38 | $1,778.28 |
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 $776.25 Median $1,148.15 Typical High $1,949.84 | Professional | None | $776.25 | $1,148.15 | $1,949.84 |
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 $389.05 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $389.05 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $575.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $77.62 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $537.03 | $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 $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
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 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· 10th of 51
$1,230
AK $2,754TX $355
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.