How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,148 to $7,943Professionalmedian $5,248 · 10th to 90th $2,570 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 $3,019.95 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,019.95 | $4,168.69 | $4,168.69 |
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 $7,413.10 | Professional | None | $3,311.31 | $4,466.84 | $7,413.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,365.16 Median $5,495.41 Typical High $6,760.83 | Professional | None | $4,365.16 | $5,495.41 | $6,760.83 |
Moda Health Setting Facility Modifier None Typical Low $4,168.69 Median $6,760.83 Typical High $7,943.28 | Facility | None | $4,168.69 | $6,760.83 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,466.84 Typical High $6,606.93 | Professional | None | $4,168.69 | $4,466.84 | $6,606.93 |
Pacific Source Setting Facility Modifier None Typical Low $3,311.31 Median $5,128.61 Typical High $5,623.41 | Facility | None | $3,311.31 | $5,128.61 | $5,623.41 |
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 $5,248.07 Typical High $8,317.64 | Professional | None | $79.43 | $5,248.07 | $8,317.64 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $14,791.08 | Facility | None | $14,791.08 | $14,791.08 | $14,791.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,370.32 Median $5,623.41 Typical High $7,413.10 | Professional | None | $5,370.32 | $5,623.41 | $7,413.10 |
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 $4,168.69 Median $5,248.07 Typical High $8,709.64 | Professional | None | $4,168.69 | $5,248.07 | $8,709.64 |
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 $1,513.56 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,513.56 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $616.60 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,290.87 | $3,090.30 | $3,090.30 |
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 $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $309.03 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,884.03 | $2,884.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,905.46 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,905.46 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $758.58 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,818.38 | $3,090.30 | $3,090.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $562.34 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $380.19 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,884.03 | $2,884.03 |
Where Oregon sits
The same service costs 5.1 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
$5,248
AK $9,772TX $1,905
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.