How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,072 to $7,943Professionalmedian $2,455 · 10th to 90th $1,288 to $3,715
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 $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,995.26 | $1,995.26 |
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 $1,621.81 Median $2,187.76 Typical High $3,630.78 | Professional | None | $1,621.81 | $2,187.76 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $3,235.94 | Professional | None | $2,089.30 | $2,630.27 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $7,943.28 | Facility | None | $1,995.26 | $3,235.94 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,995.26 | $2,089.30 | $3,162.28 |
Pacific Source Setting Facility Modifier None Typical Low $1,584.89 Median $2,570.40 Typical High $2,754.23 | Facility | None | $1,584.89 | $2,570.40 | $2,754.23 |
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 $2,454.71 Typical High $3,981.07 | Professional | None | $79.43 | $2,454.71 | $3,981.07 |
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 $2,570.40 Median $2,754.23 Typical High $3,548.13 | Professional | None | $2,570.40 | $2,754.23 | $3,548.13 |
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 $1,995.26 Median $2,511.89 Typical High $4,168.69 | Professional | None | $1,995.26 | $2,511.89 | $4,168.69 |
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 $741.31 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $741.31 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $295.12 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,096.48 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $218.78 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $147.91 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $933.25 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $371.54 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,380.38 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $275.42 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $186.21 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,412.54 | $1,412.54 |
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· 9th of 51
$2,455
AK $4,677TX $871
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.