How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,096 to $5,129Professionalmedian $2,138 · 10th to 90th $1,023 to $3,236
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 $1,023.29 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,659.59 | $1,659.59 |
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 $1,513.56 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,949.84 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,344.23 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $7,943.28 | Facility | None | $1,659.59 | $2,691.53 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,819.70 | $2,951.21 |
Pacific Source Setting Facility Modifier None Typical Low $1,318.26 Median $2,187.76 Typical High $2,290.87 | Facility | None | $1,318.26 | $2,187.76 | $2,290.87 |
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 $2,137.96 Typical High $3,311.31 | Professional | None | $79.43 | $2,137.96 | $3,311.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Facility | None | $5,888.44 | $5,888.44 | $5,888.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,137.96 Median $2,290.87 Typical High $3,388.44 | Professional | None | $2,137.96 | $2,290.87 | $3,388.44 |
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 $1,659.59 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,659.59 | $2,454.71 | $3,890.45 |
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 $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $676.08 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $269.15 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,000.00 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $134.90 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $933.25 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $831.76 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $331.13 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,148.15 |
Where Oregon sits
The same service costs 6.8 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· 9th of 51
$2,138
AK $4,571TX $676
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.