How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,905 to $19,953Professionalmedian $3,020 · 10th to 90th $1,622 to $4,467
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 $15,488.17 Typical High $33,884.42 | Facility | None | $5,128.61 | $15,488.17 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,089.30 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $17,782.79 Typical High $24,547.09 | Facility | None | $870.96 | $17,782.79 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $4,466.84 | Professional | None | $1,698.24 | $2,691.53 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,981.07 | Professional | None | $2,754.23 | $3,235.94 | $3,981.07 |
Moda Health Setting Facility Modifier None Typical Low $2,511.89 Median $4,570.88 Typical High $33,884.42 | Facility | None | $2,511.89 | $4,570.88 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $3,630.78 | Professional | None | $2,290.87 | $2,511.89 | $3,630.78 |
Pacific Source Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $3,311.31 | Facility | None | $1,905.46 | $3,162.28 | $3,311.31 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $15,848.93 Typical High $22,908.68 | Facility | None | $1,023.29 | $15,848.93 | $22,908.68 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,019.95 Typical High $4,466.84 | Professional | None | $79.43 | $3,019.95 | $4,466.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,378.01 Median $53,703.18 Typical High $74,131.02 | Facility | None | $17,378.01 | $53,703.18 | $74,131.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,162.28 Median $3,311.31 Typical High $4,365.16 | Professional | None | $3,162.28 | $3,311.31 | $4,365.16 |
United Setting Facility Modifier None Typical Low $2,951.21 Median $6,918.31 Typical High $50,118.72 | Facility | None | $2,951.21 | $6,918.31 | $50,118.72 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,951.21 Typical High $4,897.79 | Professional | None | $1,949.84 | $2,951.21 | $4,897.79 |
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 $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $933.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $371.54 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,412.54 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $281.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $457.09 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,584.89 |
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· 8th of 51
$3,162
AK $6,607TX $389
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.