How much rates vary
Facilitymedian $955 · 10th to 90th $575 to $5,129Professionalmedian $891 · 10th to 90th $427 to $1,445
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $794.33 | Professional | None | $426.58 | $691.83 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,344.23 Typical High $3,162.28 | Facility | None | $891.25 | $2,344.23 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,380.38 | Professional | None | $660.69 | $891.25 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,288.25 | Professional | None | $912.01 | $1,047.13 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $1,258.93 Typical High $8,709.64 | Facility | None | $758.58 | $1,258.93 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,318.26 | Professional | None | $489.78 | $776.25 | $1,318.26 |
Pacific Source Setting Facility Modifier None Typical Low $562.34 Median $891.25 Typical High $1,000.00 | Facility | None | $562.34 | $891.25 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,137.96 Typical High $3,162.28 | Facility | None | $812.83 | $2,137.96 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $891.25 Typical High $1,445.44 | Professional | None | $79.43 | $891.25 | $1,445.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $9,772.37 Typical High $11,220.18 | Facility | None | $4,570.88 | $9,772.37 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,479.11 | Professional | None | $954.99 | $1,000.00 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,737.80 | Professional | None | $724.44 | $1,000.00 | $1,737.80 |
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 $257.04 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $257.04 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $102.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $389.05 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $77.62 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $51.29 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $363.08 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $524.81 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $489.78 |
Where Oregon sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 14th of 51
$955
AK $2,042UT $372
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.