How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,122 to $7,943Professionalmedian $5,012 · 10th to 90th $2,512 to $7,586
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 $2,951.21 Median $4,265.80 Typical High $4,265.80 | Professional | None | $2,951.21 | $4,265.80 | $4,265.80 |
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 $3,311.31 Median $4,466.84 Typical High $7,585.78 | Professional | None | $3,311.31 | $4,466.84 | $7,585.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,073.80 Median $5,128.61 Typical High $6,456.54 | Professional | None | $4,073.80 | $5,128.61 | $6,456.54 |
Moda Health Setting Facility Modifier None Typical Low $4,265.80 Median $6,760.83 Typical High $7,943.28 | Facility | None | $4,265.80 | $6,760.83 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $3,981.07 Median $4,265.80 Typical High $6,309.57 | Professional | None | $3,981.07 | $4,265.80 | $6,309.57 |
Pacific Source Setting Facility Modifier None Typical Low $3,162.28 Median $5,248.07 Typical High $5,495.41 | Facility | None | $3,162.28 | $5,248.07 | $5,495.41 |
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 $5,011.87 Typical High $7,943.28 | Professional | None | $79.43 | $5,011.87 | $7,943.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $14,454.40 Typical High $14,454.40 | Facility | None | $14,454.40 | $14,454.40 | $14,454.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,248.07 Median $5,495.41 Typical High $7,244.36 | Professional | None | $5,248.07 | $5,495.41 | $7,244.36 |
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 $3,981.07 Median $5,011.87 Typical High $8,317.64 | Professional | None | $3,981.07 | $5,011.87 | $8,317.64 |
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 $1,548.82 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,548.82 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $616.60 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,290.87 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $457.09 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $309.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,951.21 | $2,951.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,949.84 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,949.84 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $776.25 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,884.03 | $3,162.28 | $3,162.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $575.44 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $389.05 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,951.21 | $2,951.21 |
Where Oregon sits
The same service costs 22.9 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
$5,012
AK $9,120TX $398
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.