How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,202 to $5,495Professionalmedian $3,715 · 10th to 90th $1,820 to $5,754
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 $2,238.72 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,238.72 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $23,988.33 | Facility | None | $549.54 | $1,000.00 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,467.37 Typical High $5,370.32 | Professional | None | $2,630.27 | $3,467.37 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $3,715.35 Typical High $4,570.88 | Professional | None | $3,235.94 | $3,715.35 | $4,570.88 |
Moda Health Setting Facility Modifier None Typical Low $2,238.72 Median $4,265.80 Typical High $7,943.28 | Facility | None | $2,238.72 | $4,265.80 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,818.38 Median $2,951.21 Typical High $5,128.61 | Professional | None | $2,818.38 | $2,951.21 | $5,128.61 |
Pacific Source Setting Facility Modifier None Typical Low $2,238.72 Median $3,715.35 Typical High $3,890.45 | Facility | None | $2,238.72 | $3,715.35 | $3,890.45 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,023.29 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,630.78 Typical High $5,754.40 | Professional | None | $79.43 | $3,630.78 | $5,754.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Facility | None | $10,232.93 | $10,232.93 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,715.35 Median $3,890.45 Typical High $5,754.40 | Professional | None | $3,715.35 | $3,890.45 | $5,754.40 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $4,073.80 Typical High $6,760.83 | Professional | None | $2,818.38 | $4,073.80 | $6,760.83 |
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 $1,122.02 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,122.02 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $446.68 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,659.59 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $331.13 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $223.87 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,479.11 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $588.84 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,238.72 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $295.12 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $2,089.30 |
Where Oregon sits
The same service costs 7.8 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
$3,715
AK $7,762TX $1,000
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.