How much rates vary
Facilitymedian $5,248 · 10th to 90th $2,399 to $7,943Professionalmedian $5,012 · 10th to 90th $2,570 to $7,762
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 $3,090.30 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,090.30 | $3,981.07 | $3,981.07 |
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 $3,235.94 Median $4,570.88 Typical High $7,762.47 | Professional | None | $3,235.94 | $4,570.88 | $7,762.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,466.84 Median $5,623.41 Typical High $6,918.31 | Professional | None | $4,466.84 | $5,623.41 | $6,918.31 |
Moda Health Setting Facility Modifier None Typical Low $4,168.69 Median $6,456.54 Typical High $7,943.28 | Facility | None | $4,168.69 | $6,456.54 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $3,981.07 Median $4,466.84 Typical High $6,760.83 | Professional | None | $3,981.07 | $4,466.84 | $6,760.83 |
Pacific Source Setting Facility Modifier None Typical Low $3,162.28 Median $5,248.07 Typical High $5,754.40 | Facility | None | $3,162.28 | $5,248.07 | $5,754.40 |
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 $5,128.61 Typical High $8,511.38 | Professional | None | $79.43 | $5,128.61 | $8,511.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $13,803.84 Median $13,803.84 Typical High $13,803.84 | Facility | None | $13,803.84 | $13,803.84 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,495.41 Median $5,888.44 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,888.44 | $7,585.78 |
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 $4,073.80 Median $5,011.87 Typical High $8,511.38 | Professional | None | $4,073.80 | $5,011.87 | $8,511.38 |
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 $1,548.82 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,548.82 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $630.96 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,344.23 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $467.74 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $309.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,818.38 | $2,818.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,819.70 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,819.70 | $1,995.26 | $1,995.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $724.44 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,754.23 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $549.54 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $363.08 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,818.38 | $2,818.38 |
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· 10th of 51
$5,129
AK $9,772TX $457
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.