How much rates vary
Facilitymedian $2,399 · 10th to 90th $1,479 to $13,804Professionalmedian $2,291 · 10th to 90th $1,202 to $3,467
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $9,549.93 Typical High $13,182.57 | Facility | None | $870.96 | $9,549.93 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,995.26 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $3,019.95 | Professional | None | $1,949.84 | $2,454.71 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $2,041.74 Median $3,467.37 Typical High $18,620.87 | Facility | None | $2,041.74 | $3,467.37 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,862.09 | $1,949.84 | $3,019.95 |
Pacific Source Setting Facility Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $2,511.89 | Facility | None | $1,479.11 | $2,290.87 | $2,511.89 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $8,709.64 Typical High $12,589.25 | Facility | None | $1,023.29 | $8,709.64 | $12,589.25 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,290.87 Typical High $3,715.35 | Professional | None | $79.43 | $2,290.87 | $3,715.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $25,118.86 Median $35,481.34 Typical High $40,738.03 | Facility | None | $25,118.86 | $35,481.34 | $40,738.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,511.89 | $3,388.44 |
United Setting Facility Modifier None Typical Low $2,951.21 Median $6,918.31 Typical High $48,977.88 | Facility | None | $2,951.21 | $6,918.31 | $48,977.88 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $3,890.45 | Professional | None | $1,819.70 | $2,290.87 | $3,890.45 |
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 $676.08 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $676.08 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $269.15 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,023.29 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $204.17 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $134.90 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $954.99 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $851.14 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $338.84 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,288.25 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $257.04 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $169.82 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,318.26 | $1,318.26 |
Where Oregon sits
The same service costs 25.7 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· 8th of 51
$2,344
AK $5,129TX $200
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.