How much rates vary
Facilitymedian $1,445 · 10th to 90th $813 to $37,154Professionalmedian $3,548 · 10th to 90th $79 to $6,026
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 $1,862.09 Median $3,548.13 Typical High $3,548.13 | Professional | None | $1,862.09 | $3,548.13 | $3,548.13 |
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 $2,570.40 Median $3,019.95 Typical High $6,918.31 | Professional | None | $2,570.40 | $3,019.95 | $6,918.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $4,365.16 | Professional | None | $2,691.53 | $3,388.44 | $4,365.16 |
Moda Health Setting Facility Modifier None Typical Low $3,548.13 Median $5,128.61 Typical High $7,943.28 | Facility | None | $3,548.13 | $5,128.61 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $3,548.13 | Professional | None | $1,905.46 | $3,548.13 | $3,548.13 |
Pacific Source Setting Facility Modifier None Typical Low $870.96 Median $1,445.44 Typical High $1,584.89 | Facility | None | $870.96 | $1,445.44 | $1,584.89 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,000.00 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,691.53 Typical High $7,413.10 | Professional | None | $79.43 | $2,691.53 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,548.13 Median $3,715.35 Typical High $5,128.61 | Professional | None | $3,548.13 | $3,715.35 | $5,128.61 |
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 $3,162.28 Median $4,265.80 Typical High $5,754.40 | Professional | None | $3,162.28 | $4,265.80 | $5,754.40 |
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 $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,258.93 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $501.19 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,905.46 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $380.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $251.19 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,621.81 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,621.81 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $660.69 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,454.71 | $2,691.53 | $2,691.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $489.78 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $331.13 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,511.89 | $2,511.89 |
Where Oregon sits
The same service costs 18.2 times more in Alaska than in New York. 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· 12th of 51
$3,548
AK $10,233NY $562
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.