How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,514 to $5,129Professionalmedian $3,236 · 10th to 90th $1,698 to $4,898
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 $1,949.84 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,691.53 | $2,691.53 |
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 $2,137.96 Median $2,884.03 Typical High $4,786.30 | Professional | None | $2,137.96 | $2,884.03 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,754.23 Median $3,467.37 Typical High $4,265.80 | Professional | None | $2,754.23 | $3,467.37 | $4,265.80 |
Moda Health Setting Facility Modifier None Typical Low $2,691.53 Median $4,168.69 Typical High $7,943.28 | Facility | None | $2,691.53 | $4,168.69 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,754.23 Typical High $4,265.80 | Professional | None | $2,691.53 | $2,754.23 | $4,265.80 |
Pacific Source Setting Facility Modifier None Typical Low $2,137.96 Median $3,388.44 Typical High $3,630.78 | Facility | None | $2,137.96 | $3,388.44 | $3,630.78 |
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 $3,311.31 Typical High $5,248.07 | Professional | None | $79.43 | $3,311.31 | $5,248.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,467.37 Median $3,630.78 Typical High $4,786.30 | Professional | None | $3,467.37 | $3,630.78 | $4,786.30 |
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 $2,630.27 Median $3,311.31 Typical High $5,623.41 | Professional | None | $2,630.27 | $3,311.31 | $5,623.41 |
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 $977.24 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $977.24 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $389.05 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,479.11 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $295.12 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $194.98 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,230.27 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $489.78 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,819.70 | $1,995.26 | $1,995.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $363.08 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $245.47 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,862.09 | $1,862.09 |
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· 10th of 51
$3,311
AK $6,310TX $1,175
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.