How much rates vary
Facilitymedian $1,175 · 10th to 90th $759 to $7,943Professionalmedian $1,175 · 10th to 90th $617 to $1,820
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 $724.44 Median $1,000.00 Typical High $1,000.00 | Professional | None | $724.44 | $1,000.00 | $1,000.00 |
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 $776.25 Median $1,096.48 Typical High $1,819.70 | Professional | None | $776.25 | $1,096.48 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,380.38 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,445.44 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,621.81 | Professional | None | $954.99 | $1,000.00 | $1,621.81 |
Pacific Source Setting Facility Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,348.96 | Facility | None | $758.58 | $1,148.15 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,000.00 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,122.02 Typical High $1,995.26 | Professional | None | $79.43 | $1,122.02 | $1,995.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,348.96 | $1,778.28 |
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 $954.99 Median $1,202.26 Typical High $2,041.74 | Professional | None | $954.99 | $1,202.26 | $2,041.74 |
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 $363.08 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $363.08 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $144.54 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $537.03 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $109.65 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $72.44 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $501.19 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $467.74 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $186.21 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $691.83 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $138.04 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $645.65 | $707.95 | $707.95 |
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
$1,175
AK $2,512TX $468
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.