How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,905 to $19,055Professionalmedian $2,951 · 10th to 90th $1,622 to $4,365
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,041.74 | $2,238.72 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $17,378.01 Typical High $23,442.29 | Facility | None | $870.96 | $17,378.01 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $4,466.84 | Professional | None | $1,698.24 | $2,630.27 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,890.45 | Professional | None | $2,754.23 | $3,235.94 | $3,890.45 |
Moda Health Setting Facility Modifier None Typical Low $2,398.83 Median $3,801.89 Typical High $7,943.28 | Facility | None | $2,398.83 | $3,801.89 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $3,630.78 | Professional | None | $2,238.72 | $2,454.71 | $3,630.78 |
Pacific Source Setting Facility Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $3,235.94 | Facility | None | $1,905.46 | $3,090.30 | $3,235.94 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $15,488.17 Typical High $22,387.21 | Facility | None | $1,023.29 | $15,488.17 | $22,387.21 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,951.21 Typical High $4,466.84 | Professional | None | $79.43 | $2,951.21 | $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 $3,090.30 Median $3,311.31 Typical High $4,265.80 | Professional | None | $3,090.30 | $3,311.31 | $4,265.80 |
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 $1,862.09 Median $2,951.21 Typical High $4,786.30 | Professional | None | $1,862.09 | $2,951.21 | $4,786.30 |
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 $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $933.25 | $1,122.02 | $1,122.02 |
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 $1,380.38 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,380.38 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $275.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,122.02 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $223.87 |
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 20.4 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
$3,090
AK $6,607TX $324
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.