How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,479 to $10,233Professionalmedian $2,399 · 10th to 90th $1,259 to $3,802
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 $1,445.44 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,949.84 | $1,949.84 |
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 $1,698.24 Median $2,344.23 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,344.23 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,187.76 | $2,511.89 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,467.37 Typical High $24,547.09 | Facility | None | $1,949.84 | $3,467.37 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,905.46 | $1,949.84 | $3,388.44 |
Pacific Source Setting Facility Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $2,570.40 | Facility | None | $1,445.44 | $2,344.23 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $1,412.54 Median $5,128.61 Typical High $7,762.47 | Facility | None | $1,412.54 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,344.23 Typical High $3,715.35 | Professional | None | $79.43 | $2,344.23 | $3,715.35 |
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 $2,454.71 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,454.71 | $2,570.40 | $3,890.45 |
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 $1,862.09 Median $2,570.40 Typical High $4,466.84 | Professional | None | $1,862.09 | $2,570.40 | $4,466.84 |
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 $724.44 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $724.44 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $288.40 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,096.48 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $218.78 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $144.54 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $977.24 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $398.11 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,380.38 |
Where Oregon sits
The same service costs 6.6 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· 12th of 51
$2,455
AK $5,248TX $794
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.