How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,349 to $4,786Professionalmedian $2,512 · 10th to 90th $1,445 to $3,890
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,778.28 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $2,238.72 | Facility | None | $1,174.90 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $3,981.07 | Professional | None | $1,513.56 | $2,344.23 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $3,630.78 | Professional | None | $2,511.89 | $2,951.21 | $3,630.78 |
Moda Health Setting Facility Modifier None Typical Low $2,041.74 Median $3,467.37 Typical High $24,547.09 | Facility | None | $2,041.74 | $3,467.37 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,995.26 | $2,187.76 | $3,162.28 |
Pacific Source Setting Facility Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $2,884.03 | Facility | None | $1,621.81 | $2,511.89 | $2,884.03 |
Providence Setting Facility Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $3,467.37 | Facility | None | $1,318.26 | $1,819.70 | $3,467.37 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,511.89 Typical High $3,981.07 | Professional | None | $79.43 | $2,511.89 | $3,981.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,754.23 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,754.23 | $2,884.03 | $3,801.89 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $4,168.69 | Professional | None | $1,621.81 | $2,511.89 | $4,168.69 |
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 $812.83 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $812.83 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $331.13 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,230.27 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $165.96 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $407.38 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Where Oregon sits
The same service costs 17.0 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
$2,512
AK $5,888TX $347
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.