How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,096 to $7,943Professionalmedian $2,570 · 10th to 90th $1,318 to $3,802
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 $1,659.59 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,659.59 | $2,089.30 | $2,089.30 |
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 $1,698.24 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,698.24 | $2,238.72 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,187.76 | $2,754.23 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $7,943.28 | Facility | None | $2,089.30 | $3,388.44 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $3,311.31 | Professional | None | $2,089.30 | $2,187.76 | $3,311.31 |
Pacific Source Setting Facility Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $2,818.38 | Facility | None | $1,659.59 | $2,691.53 | $2,818.38 |
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 $2,570.40 Typical High $4,168.69 | Professional | None | $79.43 | $2,570.40 | $4,168.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $3,715.35 | Professional | None | $2,691.53 | $2,818.38 | $3,715.35 |
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 $2,089.30 Median $2,570.40 Typical High $4,365.16 | Professional | None | $2,089.30 | $2,570.40 | $4,365.16 |
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 $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $776.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $309.03 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,148.15 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $229.09 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $154.88 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $954.99 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $380.19 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,445.44 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $190.55 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,479.11 | $1,479.11 |
Where Oregon sits
The same service costs 5.2 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
$2,570
AK $4,898TX $933
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.