How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,622 to $8,318Professionalmedian $2,692 · 10th to 90th $1,380 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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,737.80 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $5,623.41 Typical High $7,762.47 | Facility | None | $870.96 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $3,981.07 | Professional | None | $1,995.26 | $2,570.40 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,754.23 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $2,398.83 Median $4,265.80 Typical High $18,620.87 | Facility | None | $2,398.83 | $4,265.80 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $3,715.35 | Professional | None | $2,089.30 | $2,238.72 | $3,715.35 |
Pacific Source Setting Facility Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $2,884.03 | Facility | None | $1,621.81 | $2,630.27 | $2,884.03 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $5,128.61 Typical High $7,413.10 | Facility | None | $1,023.29 | $5,128.61 | $7,413.10 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,691.53 Typical High $4,168.69 | Professional | None | $79.43 | $2,691.53 | $4,168.69 |
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 $2,691.53 Median $2,818.38 Typical High $4,265.80 | Professional | None | $2,691.53 | $2,818.38 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $4,897.79 | Professional | None | $2,041.74 | $3,162.28 | $4,897.79 |
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 $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $346.74 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,288.25 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $257.04 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $173.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,513.56 | $1,513.56 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $436.52 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,621.81 |
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 $218.78 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,513.56 |
Where Oregon sits
The same service costs 6.5 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· 11th of 51
$2,692
AK $5,754TX $891
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.