How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,380 to $8,511Professionalmedian $5,754 · 10th to 90th $2,884 to $8,710
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 $3,630.78 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,630.78 | $4,365.16 | $4,365.16 |
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 $3,890.45 Median $5,248.07 Typical High $7,943.28 | Professional | None | $3,890.45 | $5,248.07 | $7,943.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,128.61 Median $5,888.44 Typical High $7,079.46 | Professional | None | $5,128.61 | $5,888.44 | $7,079.46 |
Moda Health Setting Facility Modifier None Typical Low $4,365.16 Median $7,244.36 Typical High $8,511.38 | Facility | None | $4,365.16 | $7,244.36 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,677.35 Typical High $8,128.31 | Professional | None | $4,365.16 | $4,677.35 | $8,128.31 |
Pacific Source Setting Facility Modifier None Typical Low $3,467.37 Median $5,623.41 Typical High $6,025.60 | Facility | None | $3,467.37 | $5,623.41 | $6,025.60 |
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 $5,754.40 Typical High $8,709.64 | Professional | None | $79.43 | $5,754.40 | $8,709.64 |
Regence BlueShield Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $16,595.87 | Facility | None | $16,595.87 | $16,595.87 | $16,595.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,754.40 Median $6,025.60 Typical High $8,912.51 | Professional | None | $5,754.40 | $6,025.60 | $8,912.51 |
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 $4,570.88 Median $6,606.93 Typical High $10,471.29 | Professional | None | $4,570.88 | $6,606.93 | $10,471.29 |
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 $1,819.70 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,819.70 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $724.44 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $2,691.53 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $537.03 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $2,511.89 | $3,090.30 | $3,090.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $2,187.76 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $870.96 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $3,311.31 | $3,311.31 | $3,311.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $436.52 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,090.30 | $3,090.30 |
Where Oregon sits
The same service costs 12.6 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· 8th of 51
$5,623
AK $12,023TX $955
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.