How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,862 to $10,715Professionalmedian $8,128 · 10th to 90th $3,890 to $12,023
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 $6,606.93 Typical High $6,606.93 | Professional | None | $4,786.30 | $6,606.93 | $6,606.93 |
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 $5,248.07 Median $6,918.31 Typical High $11,748.98 | Professional | None | $5,248.07 | $6,918.31 | $11,748.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,760.83 Median $8,709.64 Typical High $10,471.29 | Professional | None | $6,760.83 | $8,709.64 | $10,471.29 |
Moda Health Setting Facility Modifier None Typical Low $6,606.93 Median $9,332.54 Typical High $12,882.50 | Facility | None | $6,606.93 | $9,332.54 | $12,882.50 |
Moda Health Setting Professional Modifier None Typical Low $6,606.93 Median $6,918.31 Typical High $10,471.29 | Professional | None | $6,606.93 | $6,918.31 | $10,471.29 |
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 $24,547.09 Median $24,547.09 Typical High $24,547.09 | Facility | None | $24,547.09 | $24,547.09 | $24,547.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $8,511.38 Median $8,912.51 Typical High $11,748.98 | Professional | None | $8,511.38 | $8,912.51 | $11,748.98 |
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 $6,606.93 Median $8,317.64 Typical High $13,803.84 | Professional | None | $6,606.93 | $8,317.64 | $13,803.84 |
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 $2,454.71 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $2,454.71 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $1,318.26 Typical High $1,318.26 | Professional | 53 · Discontinued | $977.24 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $4,897.79 Typical High $4,897.79 | Professional | 54 · Surgery only | $3,630.78 | $4,897.79 | $4,897.79 |
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 $489.78 Median $660.69 Typical High $660.69 | Professional | 56 · Pre-op care only | $489.78 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $4,570.88 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $3,388.44 | $4,570.88 | $4,570.88 |
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 $1,318.26 Typical High $1,318.26 | Professional | 53 · Discontinued | $1,174.90 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4,466.84 Median $4,897.79 Typical High $4,897.79 | Professional | 54 · Surgery only | $4,466.84 | $4,897.79 | $4,897.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | 55 · Aftercare only | $891.25 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 56 · Pre-op care only | $588.84 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,168.69 Median $4,570.88 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $4,168.69 | $4,570.88 | $4,570.88 |
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
$8,128
AK $15,136TX $692
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.