How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,288 to $11,749Professionalmedian $1,950 · 10th to 90th $1,023 to $2,951
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 $2,041.74 Median $10,232.93 Typical High $24,547.09 | Facility | None | $2,041.74 | $10,232.93 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,412.54 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,778.28 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,659.59 | $2,041.74 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $1,659.59 Median $3,162.28 Typical High $21,379.62 | Facility | None | $1,659.59 | $3,162.28 | $21,379.62 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,659.59 | $2,570.40 |
Pacific Source Setting Facility Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $2,187.76 | Facility | None | $1,288.25 | $1,995.26 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $1,412.54 Median $5,128.61 Typical High $7,762.47 | Facility | None | $1,412.54 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,949.84 Typical High $3,162.28 | Professional | None | $79.43 | $1,949.84 | $3,162.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $20,417.38 Typical High $23,442.29 | Facility | None | $14,454.40 | $20,417.38 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,187.76 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,584.89 | $1,995.26 | $3,388.44 |
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 $575.44 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $575.44 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $234.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $870.96 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $173.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $114.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $812.83 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $758.58 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $302.00 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,148.15 |
Where Oregon sits
The same service costs 6.2 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
$1,995
AK $4,365TX $708
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.