How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,380 to $8,913Professionalmedian $6,607 · 10th to 90th $3,236 to $9,772
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 $3,890.45 Median $5,248.07 Typical High $5,248.07 | Professional | None | $3,890.45 | $5,248.07 | $5,248.07 |
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 $4,168.69 Median $5,623.41 Typical High $9,332.54 | Professional | None | $4,168.69 | $5,623.41 | $9,332.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,495.41 Median $6,918.31 Typical High $8,511.38 | Professional | None | $5,495.41 | $6,918.31 | $8,511.38 |
Moda Health Setting Facility Modifier None Typical Low $5,248.07 Median $7,943.28 Typical High $10,471.29 | Facility | None | $5,248.07 | $7,943.28 | $10,471.29 |
Moda Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,495.41 Typical High $8,317.64 | Professional | None | $5,248.07 | $5,495.41 | $8,317.64 |
Pacific Source Setting Facility Modifier None Typical Low $4,265.80 Median $6,760.83 Typical High $7,413.10 | Facility | None | $4,265.80 | $6,760.83 | $7,413.10 |
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 $10,471.29 | Professional | None | $79.43 | $6,606.93 | $10,471.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,054.61 Median $19,054.61 Typical High $19,054.61 | Facility | None | $19,054.61 | $19,054.61 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $6,760.83 Median $7,079.46 Typical High $9,332.54 | Professional | None | $6,760.83 | $7,079.46 | $9,332.54 |
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 $5,248.07 Median $6,606.93 Typical High $11,220.18 | Professional | None | $5,248.07 | $6,606.93 | $11,220.18 |
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 $1,995.26 Median $2,630.27 Typical High $2,630.27 | Professional | 52 · Reduced service | $1,995.26 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $794.33 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,981.07 Typical High $3,981.07 | Professional | 54 · Surgery only | $2,951.21 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $794.33 Typical High $794.33 | Professional | 55 · Aftercare only | $588.84 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $524.81 Typical High $524.81 | Professional | 56 · Pre-op care only | $398.11 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $3,715.35 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,754.23 | $3,715.35 | $3,715.35 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,398.83 Median $2,630.27 Typical High $2,630.27 | Professional | 52 · Reduced service | $2,398.83 | $2,630.27 | $2,630.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $954.99 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $3,981.07 Typical High $3,981.07 | Professional | 54 · Surgery only | $3,548.13 | $3,981.07 | $3,981.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $794.33 Typical High $794.33 | Professional | 55 · Aftercare only | $724.44 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 56 · Pre-op care only | $478.63 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,311.31 Median $3,715.35 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $3,311.31 | $3,715.35 | $3,715.35 |
Where Oregon sits
The same service costs 21.9 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· 9th of 51
$6,607
AK $12,303TX $562
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.