How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,380 to $8,511Professionalmedian $6,607 · 10th to 90th $3,162 to $10,233
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 $4,168.69 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,168.69 | $5,011.87 | $5,011.87 |
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 $4,570.88 Median $6,025.60 Typical High $9,120.11 | Professional | None | $4,570.88 | $6,025.60 | $9,120.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,025.60 Median $6,918.31 Typical High $8,317.64 | Professional | None | $6,025.60 | $6,918.31 | $8,317.64 |
Moda Health Setting Facility Modifier None Typical Low $5,011.87 Median $7,943.28 Typical High $9,772.37 | Facility | None | $5,011.87 | $7,943.28 | $9,772.37 |
Moda Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,495.41 Typical High $9,332.54 | Professional | None | $5,011.87 | $5,495.41 | $9,332.54 |
Pacific Source Setting Facility Modifier None Typical Low $3,981.07 Median $6,456.54 Typical High $6,918.31 | Facility | None | $3,981.07 | $6,456.54 | $6,918.31 |
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 $6,606.93 Typical High $10,232.93 | Professional | None | $79.43 | $6,606.93 | $10,232.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $18,197.01 | Facility | None | $18,197.01 | $18,197.01 | $18,197.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $6,606.93 Median $6,918.31 Typical High $10,471.29 | Professional | None | $6,606.93 | $6,918.31 | $10,471.29 |
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 $5,248.07 Median $7,585.78 Typical High $12,022.64 | Professional | None | $5,248.07 | $7,585.78 | $12,022.64 |
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 $2,089.30 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,089.30 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $831.76 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $3,162.28 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $630.96 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $416.87 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,951.21 | $3,548.13 | $3,548.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,511.89 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $1,000.00 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $3,801.89 | $3,801.89 | $3,801.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $3,548.13 | $3,548.13 | $3,548.13 |
Where Oregon sits
The same service costs 10.7 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
$6,607
AK $14,125TX $1,318
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.