How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,259 to $5,623Professionalmedian $1,995 · 10th to 90th $1,072 to $3,020
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,691.53 Typical High $3,630.78 | Facility | None | $891.25 | $2,691.53 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,819.70 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,778.28 | $2,238.72 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,659.59 Median $3,019.95 Typical High $8,709.64 | Facility | None | $1,659.59 | $3,019.95 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,621.81 | $1,737.80 | $2,630.27 |
Pacific Source Setting Facility Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $2,238.72 | Facility | None | $1,258.93 | $2,089.30 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $2,630.27 Typical High $3,630.78 | Facility | None | $912.01 | $2,630.27 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,995.26 Typical High $3,235.94 | Professional | None | $79.43 | $1,995.26 | $3,235.94 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $9,772.37 Typical High $11,220.18 | Facility | None | $6,918.31 | $9,772.37 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,238.72 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,584.89 | $1,995.26 | $3,311.31 |
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 $602.56 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $602.56 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $245.47 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $912.01 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $181.97 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $123.03 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $851.14 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $758.58 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $302.00 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $229.09 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,174.90 |
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· 11th of 51
$2,042
AK $3,981TX $759
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.