How much rates vary
Facilitymedian $1,950 · 10th to 90th $1,175 to $5,248Professionalmedian $1,905 · 10th to 90th $1,047 to $2,951
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,905.46 Typical High $2,570.40 | Facility | None | $870.96 | $1,905.46 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,819.70 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,995.26 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,445.44 | $2,884.03 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,548.82 | $2,691.53 |
Pacific Source Setting Facility Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $2,041.74 | Facility | None | $1,174.90 | $1,949.84 | $2,041.74 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $1,949.84 Typical High $2,570.40 | Facility | None | $1,023.29 | $1,949.84 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,905.46 Typical High $2,951.21 | Professional | None | $79.43 | $1,905.46 | $2,951.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $9,120.11 | Facility | None | $5,248.07 | $7,585.78 | $9,120.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,949.84 | $2,041.74 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,479.11 | $2,137.96 | $3,548.13 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $933.25 |
Where Oregon sits
The same service costs 5.9 times more in Alaska than in Utah. 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
$1,950
AK $4,074UT $692
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.