How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,072 to $10,233Professionalmedian $7,413 · 10th to 90th $3,890 to $11,482
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 $4,570.88 Median $6,309.57 Typical High $6,309.57 | Professional | None | $4,570.88 | $6,309.57 | $6,309.57 |
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 $5,011.87 Median $6,760.83 Typical High $11,481.54 | Professional | None | $5,011.87 | $6,760.83 | $11,481.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,606.93 Median $8,317.64 Typical High $10,000.00 | Professional | None | $6,606.93 | $8,317.64 | $10,000.00 |
Moda Health Setting Facility Modifier None Typical Low $6,309.57 Median $8,128.31 Typical High $10,715.19 | Facility | None | $6,309.57 | $8,128.31 | $10,715.19 |
Moda Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,456.54 Typical High $10,000.00 | Professional | None | $6,165.95 | $6,456.54 | $10,000.00 |
Pacific Source Setting Facility Modifier None Typical Low $5,011.87 Median $7,762.47 Typical High $8,511.38 | Facility | None | $5,011.87 | $7,762.47 | $8,511.38 |
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 $7,413.10 Typical High $12,589.25 | Professional | None | $79.43 | $7,413.10 | $12,589.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $21,877.62 Median $21,877.62 Typical High $21,877.62 | Facility | None | $21,877.62 | $21,877.62 | $21,877.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $8,128.31 Median $8,511.38 Typical High $11,220.18 | Professional | None | $8,128.31 | $8,511.38 | $11,220.18 |
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 $6,165.95 Median $7,762.47 Typical High $13,182.57 | Professional | None | $6,165.95 | $7,762.47 | $13,182.57 |
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 $2,290.87 Median $3,162.28 Typical High $3,162.28 | Professional | 52 · Reduced service | $2,290.87 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | 53 · Discontinued | $933.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $4,677.35 Typical High $4,677.35 | Professional | 54 · Surgery only | $3,467.37 | $4,677.35 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $933.25 Typical High $933.25 | Professional | 55 · Aftercare only | $691.83 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $630.96 Typical High $630.96 | Professional | 56 · Pre-op care only | $467.74 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $4,365.16 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $3,235.94 | $4,365.16 | $4,365.16 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,884.03 Median $3,162.28 Typical High $3,162.28 | Professional | 52 · Reduced service | $2,884.03 | $3,162.28 | $3,162.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | 53 · Discontinued | $1,148.15 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4,265.80 Median $4,677.35 Typical High $4,677.35 | Professional | 54 · Surgery only | $4,265.80 | $4,677.35 | $4,677.35 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | 55 · Aftercare only | $851.14 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 56 · Pre-op care only | $575.44 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,981.07 Median $4,365.16 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $3,981.07 | $4,365.16 | $4,365.16 |
Where Oregon sits
The same service costs 20.9 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· 9th of 51
$7,586
AK $14,125TX $676
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.