How much rates vary
Facilitymedian $1,622 · 10th to 90th $1,000 to $13,183Professionalmedian $1,514 · 10th to 90th $891 to $2,344
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 $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,122.02 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $9,549.93 Typical High $13,182.57 | Facility | None | $1,000.00 | $9,549.93 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $2,454.71 | Professional | None | $912.01 | $1,445.44 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,862.09 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,238.72 Typical High $17,378.01 | Facility | None | $1,412.54 | $2,238.72 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,318.26 | $1,995.26 |
Pacific Source Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $1,737.80 | Facility | None | $954.99 | $1,548.82 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $8,709.64 Typical High $13,182.57 | Facility | None | $1,047.13 | $8,709.64 | $13,182.57 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,513.56 Typical High $2,398.83 | Professional | None | $79.43 | $1,513.56 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,782.79 Median $25,118.86 Typical High $28,183.83 | Facility | None | $17,782.79 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,737.80 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,479.11 | $2,511.89 |
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 $489.78 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $97.72 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $616.60 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $933.25 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $870.96 |
Where Oregon sits
The same service costs 7.6 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
$1,585
AK $3,548TX $468
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.