How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,023 to $5,495Professionalmedian $2,344 · 10th to 90th $1,230 to $3,548
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 $1,412.54 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,949.84 | $1,949.84 |
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 $1,548.82 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,548.82 | $2,089.30 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,570.40 Typical High $3,162.28 | Professional | None | $2,041.74 | $2,570.40 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,090.30 Typical High $7,943.28 | Facility | None | $1,949.84 | $3,090.30 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,949.84 | $2,041.74 | $3,090.30 |
Pacific Source Setting Facility Modifier None Typical Low $1,548.82 Median $2,511.89 Typical High $2,630.27 | Facility | None | $1,548.82 | $2,511.89 | $2,630.27 |
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 $2,398.83 Typical High $3,890.45 | Professional | None | $79.43 | $2,398.83 | $3,890.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Facility | None | $6,760.83 | $6,760.83 | $6,760.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $3,467.37 | Professional | None | $2,511.89 | $2,630.27 | $3,467.37 |
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 $1,905.46 Median $2,398.83 Typical High $4,073.80 | Professional | None | $1,905.46 | $2,398.83 | $4,073.80 |
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 $707.95 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $707.95 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $281.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,071.52 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $213.80 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $141.25 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $891.25 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $354.81 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,318.26 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $269.15 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,348.96 | $1,348.96 |
Where Oregon sits
The same service costs 5.4 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· 9th of 51
$2,399
AK $4,571TX $851
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.