How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,514 to $7,943Professionalmedian $2,344 · 10th to 90th $1,230 to $3,467
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 $1,905.46 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,905.46 | $1,905.46 |
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 $1,513.56 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,513.56 | $2,041.74 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,090.30 | Professional | None | $1,995.26 | $2,511.89 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $7,943.28 | Facility | None | $1,905.46 | $3,019.95 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,905.46 | $1,995.26 | $3,019.95 |
Pacific Source Setting Facility Modifier None Typical Low $1,513.56 Median $2,454.71 Typical High $2,570.40 | Facility | None | $1,513.56 | $2,454.71 | $2,570.40 |
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 $2,344.23 Typical High $3,801.89 | Professional | None | $79.43 | $2,344.23 | $3,801.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,570.40 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,981.07 | Professional | None | $1,862.09 | $2,344.23 | $3,981.07 |
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 $691.83 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $691.83 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $275.42 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,047.13 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $208.93 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $138.04 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $870.96 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $346.74 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,318.26 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $263.03 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $173.78 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,318.26 | $1,318.26 |
Where Oregon sits
The same service costs 26.3 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
$2,344
AK $5,248TX $200
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.