How much rates vary
Facilitymedian $6,918 · 10th to 90th $3,631 to $10,715Professionalmedian $6,607 · 10th to 90th $3,802 to $10,233
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 $4,570.88 Median $5,370.32 Typical High $5,370.32 | Professional | None | $4,570.88 | $5,370.32 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $8,709.64 Typical High $12,022.64 | Facility | None | $870.96 | $8,709.64 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $6,165.95 Typical High $10,471.29 | Professional | None | $3,890.45 | $6,165.95 | $10,471.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,456.54 Median $7,585.78 Typical High $9,120.11 | Professional | None | $6,456.54 | $7,585.78 | $9,120.11 |
Moda Health Setting Facility Modifier None Typical Low $5,888.44 Median $7,943.28 Typical High $18,620.87 | Facility | None | $5,888.44 | $7,943.28 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $8,511.38 | Professional | None | $5,370.32 | $5,495.41 | $8,511.38 |
Pacific Source Setting Facility Modifier None Typical Low $4,365.16 Median $6,309.57 Typical High $7,585.78 | Facility | None | $4,365.16 | $6,309.57 | $7,585.78 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $8,128.31 Typical High $11,220.18 | Facility | None | $1,023.29 | $8,128.31 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $6,309.57 Typical High $10,471.29 | Professional | None | $79.43 | $6,309.57 | $10,471.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $21,379.62 Typical High $29,512.09 | Facility | None | $9,332.54 | $21,379.62 | $29,512.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $7,244.36 Median $7,585.78 Typical High $9,772.37 | Professional | None | $7,244.36 | $7,585.78 | $9,772.37 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $11,220.18 | Professional | None | $4,570.88 | $6,760.83 | $11,220.18 |
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 $2,187.76 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $2,187.76 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $870.96 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,235.94 Median $3,981.07 Typical High $3,981.07 | Professional | 54 · Surgery only | $3,235.94 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 55 · Aftercare only | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $436.52 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,019.95 Median $3,715.35 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $3,019.95 | $3,715.35 | $3,715.35 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $2,691.53 | $2,691.53 | $2,691.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | 54 · Surgery only | $3,981.07 | $3,981.07 | $3,981.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 55 · Aftercare only | $794.33 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $537.03 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $3,715.35 | $3,715.35 | $3,715.35 |
Where Oregon sits
The same service costs 20.4 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
$6,761
AK $15,488TX $759
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.