How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,148 to $7,943Professionalmedian $3,090 · 10th to 90th $1,622 to $4,571
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 $1,778.28 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,778.28 | $2,511.89 | $2,511.89 |
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 $2,041.74 Median $2,691.53 Typical High $4,570.88 | Professional | None | $2,041.74 | $2,691.53 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $3,981.07 | Professional | None | $2,630.27 | $3,311.31 | $3,981.07 |
Moda Health Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $7,943.28 | Facility | None | $2,511.89 | $3,981.07 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $3,981.07 | Professional | None | $2,511.89 | $2,630.27 | $3,981.07 |
Pacific Source Setting Facility Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $3,467.37 | Facility | None | $1,995.26 | $3,090.30 | $3,467.37 |
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 $3,090.30 Typical High $5,011.87 | Professional | None | $79.43 | $3,090.30 | $5,011.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Facility | None | $8,709.64 | $8,709.64 | $8,709.64 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,235.94 Median $3,467.37 Typical High $4,466.84 | Professional | None | $3,235.94 | $3,467.37 | $4,466.84 |
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 $2,511.89 Median $3,162.28 Typical High $5,248.07 | Professional | None | $2,511.89 | $3,162.28 | $5,248.07 |
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 $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $933.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $371.54 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,380.38 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $275.42 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $186.21 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,148.15 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $457.09 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,737.80 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $346.74 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $229.09 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,778.28 | $1,778.28 |
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
$3,090
AK $5,888TX $1,096
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.