How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,380 to $5,495Professionalmedian $2,630 · 10th to 90th $1,259 to $4,074
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 $1,659.59 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,995.26 | $1,995.26 |
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 $1,819.70 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,819.70 | $2,398.83 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,818.38 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $2,238.72 Median $3,090.30 Typical High $7,943.28 | Facility | None | $2,238.72 | $3,090.30 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,187.76 | $3,715.35 |
Pacific Source Setting Facility Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $2,754.23 | Facility | None | $1,621.81 | $2,511.89 | $2,754.23 |
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 $2,570.40 Typical High $4,073.80 | Professional | None | $79.43 | $2,570.40 | $4,073.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $4,073.80 | Professional | None | $2,630.27 | $2,754.23 | $4,073.80 |
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 $2,041.74 Median $2,818.38 Typical High $4,786.30 | Professional | None | $2,041.74 | $2,818.38 | $4,786.30 |
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 $831.76 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $831.76 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $331.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,230.27 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,000.00 |
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Where Oregon sits
The same service costs 7.4 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
$2,570
AK $5,623TX $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.