How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,862 to $7,943Professionalmedian $4,467 · 10th to 90th $2,188 to $6,607
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 $2,398.83 Median $3,630.78 Typical High $3,630.78 | Professional | None | $2,398.83 | $3,630.78 | $3,630.78 |
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 $2,951.21 Median $3,890.45 Typical High $6,606.93 | Professional | None | $2,951.21 | $3,890.45 | $6,606.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,715.35 Median $4,677.35 Typical High $5,754.40 | Professional | None | $3,715.35 | $4,677.35 | $5,754.40 |
Moda Health Setting Facility Modifier None Typical Low $3,630.78 Median $5,754.40 Typical High $20,892.96 | Facility | None | $3,630.78 | $5,754.40 | $20,892.96 |
Moda Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,754.40 | Professional | None | $3,311.31 | $3,715.35 | $5,754.40 |
Pacific Source Setting Facility Modifier None Typical Low $2,884.03 Median $4,570.88 Typical High $4,897.79 | Facility | None | $2,884.03 | $4,570.88 | $4,897.79 |
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 $4,466.84 Typical High $7,244.36 | Professional | None | $79.43 | $4,466.84 | $7,244.36 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,677.35 Median $4,897.79 Typical High $6,456.54 | Professional | None | $4,677.35 | $4,897.79 | $6,456.54 |
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 $3,630.78 Median $4,570.88 Typical High $7,585.78 | Professional | None | $3,630.78 | $4,570.88 | $7,585.78 |
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 $1,348.96 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,348.96 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $537.03 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,995.26 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $398.11 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $269.15 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,659.59 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,659.59 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $660.69 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,511.89 | $2,754.23 | $2,754.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $501.19 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $331.13 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,570.40 | $2,570.40 |
Where Oregon sits
The same service costs 21.4 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
$4,467
AK $8,318TX $389
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.