How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,698 to $7,762Professionalmedian $2,818 · 10th to 90th $1,479 to $4,169
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 $1,949.84 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,949.84 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,090.30 Typical High $4,168.69 | Facility | None | $870.96 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $4,168.69 | Professional | None | $1,584.89 | $2,511.89 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $3,715.35 | Professional | None | $2,630.27 | $3,019.95 | $3,715.35 |
Moda Health Setting Facility Modifier None Typical Low $2,137.96 Median $4,265.80 Typical High $24,547.09 | Facility | None | $2,137.96 | $4,265.80 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,137.96 | $3,388.44 |
Pacific Source Setting Facility Modifier None Typical Low $1,659.59 Median $2,884.03 Typical High $3,090.30 | Facility | None | $1,659.59 | $2,884.03 | $3,090.30 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $3,019.95 Typical High $4,168.69 | Facility | None | $1,023.29 | $3,019.95 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,818.38 Typical High $4,265.80 | Professional | None | $79.43 | $2,818.38 | $4,265.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,943.28 Median $21,379.62 Typical High $29,512.09 | Facility | None | $7,943.28 | $21,379.62 | $29,512.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,951.21 Median $3,090.30 Typical High $4,073.80 | Professional | None | $2,951.21 | $3,090.30 | $4,073.80 |
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 $1,778.28 Median $2,754.23 Typical High $4,570.88 | Professional | None | $1,778.28 | $2,754.23 | $4,570.88 |
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 $870.96 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $870.96 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $346.74 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,318.26 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $263.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $426.58 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,479.11 |
Where Oregon sits
The same service costs 8.5 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
$2,884
AK $6,166TX $724
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.