How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,622 to $10,233Professionalmedian $2,512 · 10th to 90th $1,413 to $3,802
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 $1,949.84 Typical High $1,949.84 | Professional | None | $1,778.28 | $1,949.84 | $1,949.84 |
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 $1,445.44 Median $2,290.87 Typical High $3,801.89 | Professional | None | $1,445.44 | $2,290.87 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,754.23 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $2,137.96 Median $3,801.89 Typical High $24,547.09 | Facility | None | $2,137.96 | $3,801.89 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,949.84 | $2,187.76 | $3,162.28 |
Pacific Source Setting Facility Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $2,818.38 | Facility | None | $1,621.81 | $2,691.53 | $2,818.38 |
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 $2,454.71 Typical High $3,890.45 | Professional | None | $79.43 | $2,454.71 | $3,890.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,244.36 Median $21,379.62 Typical High $29,512.09 | Facility | None | $7,244.36 | $21,379.62 | $29,512.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $3,715.35 | Professional | None | $2,691.53 | $2,818.38 | $3,715.35 |
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 $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 $794.33 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $794.33 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $316.23 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,202.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $158.49 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $977.24 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $389.05 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,380.38 |
Where Oregon sits
The same service costs 18.6 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· 9th of 51
$2,692
AK $5,623TX $302
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.