How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,995 to $10,715Professionalmedian $3,090 · 10th to 90th $1,698 to $4,571
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 $1,584.89 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,584.89 | $2,344.23 | $2,344.23 |
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 $1,778.28 Median $2,754.23 Typical High $4,677.35 | Professional | None | $1,778.28 | $2,754.23 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $4,073.80 | Professional | None | $2,884.03 | $3,388.44 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $24,547.09 | Facility | None | $2,630.27 | $4,677.35 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,801.89 | Professional | None | $2,137.96 | $2,511.89 | $3,801.89 |
Pacific Source Setting Facility Modifier None Typical Low $1,995.26 Median $3,162.28 Typical High $3,467.37 | Facility | None | $1,995.26 | $3,162.28 | $3,467.37 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $7,943.28 Typical High $11,220.18 | Facility | None | $1,023.29 | $7,943.28 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,162.28 Typical High $4,677.35 | Professional | None | $79.43 | $3,162.28 | $4,677.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,709.64 Median $21,379.62 Typical High $29,512.09 | Facility | None | $8,709.64 | $21,379.62 | $29,512.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,235.94 Median $3,467.37 Typical High $4,466.84 | Professional | None | $3,235.94 | $3,467.37 | $4,466.84 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $3,090.30 Typical High $5,011.87 | Professional | None | $2,089.30 | $3,090.30 | $5,011.87 |
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 $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $977.24 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $389.05 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,445.44 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $288.40 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $194.98 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $478.63 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,659.59 |
Where Oregon sits
The same service costs 9.3 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
$3,236
AK $6,918TX $741
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.