How much rates vary
Facilitymedian $8,318 · 10th to 90th $2,138 to $10,233Professionalmedian $8,128 · 10th to 90th $3,802 to $11,749
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 $4,786.30 Median $6,456.54 Typical High $6,456.54 | Professional | None | $4,786.30 | $6,456.54 | $6,456.54 |
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 $5,128.61 Median $6,760.83 Typical High $11,481.54 | Professional | None | $5,128.61 | $6,760.83 | $11,481.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,606.93 Median $8,511.38 Typical High $10,232.93 | Professional | None | $6,606.93 | $8,511.38 | $10,232.93 |
Moda Health Setting Facility Modifier None Typical Low $6,456.54 Median $9,120.11 Typical High $12,302.69 | Facility | None | $6,456.54 | $9,120.11 | $12,302.69 |
Moda Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,760.83 Typical High $10,232.93 | Professional | None | $6,456.54 | $6,760.83 | $10,232.93 |
Pacific Source Setting Facility Modifier None Typical Low $5,248.07 Median $8,317.64 Typical High $9,120.11 | Facility | None | $5,248.07 | $8,317.64 | $9,120.11 |
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 $8,317.64 Typical High $12,882.50 | Professional | None | $79.43 | $8,317.64 | $12,882.50 |
Regence BlueShield Setting Facility Modifier None Typical Low $23,442.29 Median $23,442.29 Typical High $23,442.29 | Facility | None | $23,442.29 | $23,442.29 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $8,317.64 Median $8,709.64 Typical High $11,481.54 | Professional | None | $8,317.64 | $8,709.64 | $11,481.54 |
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 $6,456.54 Median $8,317.64 Typical High $13,489.63 | Professional | None | $6,456.54 | $8,317.64 | $13,489.63 |
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 $2,398.83 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $2,398.83 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $977.24 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $3,630.78 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $977.24 Typical High $977.24 | Professional | 55 · Aftercare only | $724.44 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $645.65 Typical High $645.65 | Professional | 56 · Pre-op care only | $478.63 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $4,466.84 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $3,388.44 | $4,466.84 | $4,466.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,951.21 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $2,951.21 | $3,235.94 | $3,235.94 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $1,174.90 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4,365.16 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $4,365.16 | $4,786.30 | $4,786.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | 55 · Aftercare only | $870.96 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | 56 · Pre-op care only | $588.84 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,073.80 Median $4,466.84 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $4,073.80 | $4,466.84 | $4,466.84 |
Where Oregon sits
The same service costs 21.4 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
$8,128
AK $14,454TX $676
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.