How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,148 to $11,749Professionalmedian $2,630 · 10th to 90th $1,349 to $3,981
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,621.81 | $2,187.76 | $2,187.76 |
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 $1,778.28 Median $2,344.23 Typical High $3,981.07 | Professional | None | $1,778.28 | $2,344.23 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,290.87 | $2,884.03 | $3,548.13 |
Moda Health Setting Facility Modifier None Typical Low $2,398.83 Median $4,073.80 Typical High $24,547.09 | Facility | None | $2,398.83 | $4,073.80 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $3,467.37 | Professional | None | $2,187.76 | $2,290.87 | $3,467.37 |
Pacific Source Setting Facility Modifier None Typical Low $1,737.80 Median $2,691.53 Typical High $2,951.21 | Facility | None | $1,737.80 | $2,691.53 | $2,951.21 |
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 $2,630.27 Typical High $4,365.16 | Professional | None | $79.43 | $2,630.27 | $4,365.16 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,918.31 | $6,918.31 | $6,918.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,818.38 Median $2,951.21 Typical High $3,890.45 | Professional | None | $2,818.38 | $2,951.21 | $3,890.45 |
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 $2,137.96 Median $2,691.53 Typical High $4,570.88 | Professional | None | $2,137.96 | $2,691.53 | $4,570.88 |
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 $794.33 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $794.33 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $323.59 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,202.26 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $239.88 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $158.49 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,000.00 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $398.11 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,513.56 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $302.00 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $199.53 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,548.82 | $1,548.82 |
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· 9th of 51
$2,692
AK $5,129TX $977
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.