How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,862 to $12,303Professionalmedian $3,020 · 10th to 90th $1,549 to $4,677
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 $3,019.95 Median $12,302.69 Typical High $33,884.42 | Facility | None | $3,019.95 | $12,302.69 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,778.28 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $5,754.40 Typical High $7,762.47 | Facility | None | $2,398.83 | $5,754.40 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,884.03 Typical High $4,466.84 | Professional | None | $2,137.96 | $2,884.03 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $3,890.45 | Professional | None | $2,754.23 | $3,162.28 | $3,890.45 |
Moda Health Setting Facility Modifier None Typical Low $2,454.71 Median $4,365.16 Typical High $19,952.62 | Facility | None | $2,454.71 | $4,365.16 | $19,952.62 |
Moda Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $4,265.80 | Professional | None | $2,238.72 | $2,454.71 | $4,265.80 |
Pacific Source Setting Facility Modifier None Typical Low $1,819.70 Median $2,754.23 Typical High $3,235.94 | Facility | None | $1,819.70 | $2,754.23 | $3,235.94 |
Providence Setting Facility Modifier None Typical Low $2,398.83 Median $5,248.07 Typical High $7,762.47 | Facility | None | $2,398.83 | $5,248.07 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,884.03 Typical High $4,677.35 | Professional | None | $79.43 | $2,884.03 | $4,677.35 |
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 $3,019.95 Median $3,235.94 Typical High $4,786.30 | Professional | None | $3,019.95 | $3,235.94 | $4,786.30 |
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 $2,344.23 Median $3,235.94 Typical High $5,495.41 | Professional | None | $2,344.23 | $3,235.94 | $5,495.41 |
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 $912.01 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $912.01 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $363.08 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,380.38 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $275.42 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $181.97 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,698.24 |
Where Oregon sits
The same service costs 6.3 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· 10th of 51
$3,020
AK $6,457UT $1,023
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.