How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,202 to $6,310Professionalmedian $4,169 · 10th to 90th $2,042 to $6,310
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 $2,454.71 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,454.71 | $3,388.44 | $3,388.44 |
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 $2,754.23 Median $3,630.78 Typical High $6,165.95 | Professional | None | $2,754.23 | $3,630.78 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,467.37 Median $4,365.16 Typical High $5,370.32 | Professional | None | $3,467.37 | $4,365.16 | $5,370.32 |
Moda Health Setting Facility Modifier None Typical Low $3,388.44 Median $4,786.30 Typical High $7,943.28 | Facility | None | $3,388.44 | $4,786.30 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,548.13 Typical High $5,370.32 | Professional | None | $3,388.44 | $3,548.13 | $5,370.32 |
Pacific Source Setting Facility Modifier None Typical Low $2,691.53 Median $4,265.80 Typical High $4,570.88 | Facility | None | $2,691.53 | $4,265.80 | $4,570.88 |
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 $4,168.69 Typical High $6,760.83 | Professional | None | $79.43 | $4,168.69 | $6,760.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Facility | None | $11,748.98 | $11,748.98 | $11,748.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,365.16 Median $4,570.88 Typical High $6,025.60 | Professional | None | $4,365.16 | $4,570.88 | $6,025.60 |
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 $3,388.44 Median $4,265.80 Typical High $7,079.46 | Professional | None | $3,388.44 | $4,265.80 | $7,079.46 |
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 $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,258.93 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $501.19 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,862.09 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $380.19 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $251.19 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,548.82 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $616.60 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,344.23 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $467.74 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $309.03 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,398.83 | $2,398.83 |
Where Oregon sits
The same service costs 22.4 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
$4,169
AK $7,943TX $355
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.