How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,514 to $11,749Professionalmedian $2,512 · 10th to 90th $1,288 to $3,981
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 $1,513.56 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,513.56 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,412.54 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,454.71 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $3,467.37 | Professional | None | $2,454.71 | $2,818.38 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $2,089.30 Median $3,090.30 Typical High $24,547.09 | Facility | None | $2,089.30 | $3,090.30 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,949.84 | $2,089.30 | $3,630.78 |
Pacific Source Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,691.53 | Facility | None | $1,513.56 | $2,344.23 | $2,691.53 |
Providence Setting Facility Modifier None Typical Low $1,445.44 Median $5,248.07 Typical High $7,762.47 | Facility | None | $1,445.44 | $5,248.07 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,290.87 Typical High $3,890.45 | Professional | None | $79.43 | $2,290.87 | $3,890.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $20,417.38 Typical High $23,442.29 | Facility | None | $14,454.40 | $20,417.38 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $3,981.07 | Professional | None | $2,570.40 | $2,691.53 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $4,677.35 | Professional | None | $1,905.46 | $2,570.40 | $4,677.35 |
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 $758.58 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $758.58 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $302.00 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,148.15 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $229.09 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $151.36 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $416.87 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,445.44 |
Where Oregon sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 15th of 51
$2,512
AK $5,495UT $933
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.