How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,148 to $7,943Professionalmedian $2,630 · 10th to 90th $1,380 to $3,890
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 $1,698.24 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,698.24 | $2,137.96 | $2,137.96 |
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 $1,737.80 Median $2,290.87 Typical High $3,890.45 | Professional | None | $1,737.80 | $2,290.87 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,290.87 | $2,884.03 | $3,548.13 |
Moda Health Setting Facility Modifier None Typical Low $2,137.96 Median $3,630.78 Typical High $7,943.28 | Facility | None | $2,137.96 | $3,630.78 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,290.87 Typical High $3,388.44 | Professional | None | $2,137.96 | $2,290.87 | $3,388.44 |
Pacific Source Setting Facility Modifier None Typical Low $1,698.24 Median $2,754.23 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,754.23 | $2,951.21 |
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 $2,691.53 Typical High $4,265.80 | Professional | None | $79.43 | $2,691.53 | $4,265.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,754.23 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,754.23 | $2,884.03 | $3,801.89 |
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 $2,137.96 Median $2,691.53 Typical High $4,466.84 | Professional | None | $2,137.96 | $2,691.53 | $4,466.84 |
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 $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $794.33 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $323.59 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,202.26 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $239.88 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $158.49 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $977.24 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $389.05 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,479.11 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $295.12 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $194.98 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,513.56 | $1,513.56 |
Where Oregon sits
The same service costs 5.0 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
$2,692
AK $5,012TX $1,000
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.