How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,380 to $8,913Professionalmedian $2,188 · 10th to 90th $912 to $3,548
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 $912.01 Median $1,819.70 Typical High $1,819.70 | Professional | None | $912.01 | $1,819.70 | $1,819.70 |
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 $1,621.81 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,621.81 | $2,187.76 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,344.23 | $2,884.03 |
Moda Health Setting Facility Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $18,620.87 | Facility | None | $1,819.70 | $2,818.38 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,819.70 | $3,162.28 |
Pacific Source Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $2,454.71 | Facility | None | $1,348.96 | $2,089.30 | $2,454.71 |
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 $2,089.30 Typical High $3,548.13 | Professional | None | $79.43 | $2,089.30 | $3,548.13 |
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 $2,344.23 Median $2,454.71 Typical High $3,630.78 | Professional | None | $2,344.23 | $2,454.71 | $3,630.78 |
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 $1,737.80 Median $2,290.87 Typical High $4,168.69 | Professional | None | $1,737.80 | $2,290.87 | $4,168.69 |
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 $676.08 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $676.08 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $275.42 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,023.29 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $204.17 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $138.04 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $954.99 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $912.01 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $363.08 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
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· 10th of 51
$2,291
AK $4,898TX $759
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.