How much rates vary
Facilitymedian $1,950 · 10th to 90th $912 to $7,943Professionalmedian $1,820 · 10th to 90th $977 to $2,754
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 $1,174.90 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,548.82 | $1,548.82 |
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 $1,202.26 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,621.81 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,659.59 | $2,041.74 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $1,995.26 Typical High $7,943.28 | Facility | None | $398.11 | $1,995.26 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,548.82 | $2,398.83 |
Pacific Source Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $2,041.74 | Facility | None | $1,174.90 | $1,905.46 | $2,041.74 |
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 $1,819.70 Typical High $2,951.21 | Professional | None | $79.43 | $1,819.70 | $2,951.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,041.74 | $2,630.27 |
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 $1,445.44 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,862.09 | $3,090.30 |
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 $549.54 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $549.54 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $218.78 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $812.83 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $162.18 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $109.65 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $758.58 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $281.84 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $213.80 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,071.52 |
Where Oregon sits
The same service costs 4.9 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
$1,862
AK $3,548TX $724
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.