How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,738 to $5,623Professionalmedian $1,318 · 10th to 90th $501 to $3,890
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 $501.19 Median $1,258.93 Typical High $2,089.30 | Professional | None | $501.19 | $1,258.93 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $2,238.72 Typical High $3,019.95 | Facility | None | $870.96 | $2,238.72 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,445.44 Typical High $3,981.07 | Professional | None | $562.34 | $1,445.44 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $3,467.37 | Professional | None | $676.08 | $1,047.13 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $4,677.35 Typical High $8,709.64 | Facility | None | $707.95 | $4,677.35 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $2,089.30 Typical High $3,548.13 | Professional | None | $501.19 | $2,089.30 | $3,548.13 |
Pacific Source Setting Facility Modifier None Typical Low $1,737.80 Median $2,754.23 Typical High $3,630.78 | Facility | None | $1,737.80 | $2,754.23 | $3,630.78 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $2,238.72 Typical High $4,677.35 | Facility | None | $741.31 | $2,238.72 | $4,677.35 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,174.90 Typical High $3,981.07 | Professional | None | $79.43 | $1,174.90 | $3,981.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,912.51 Median $12,589.25 Typical High $13,803.84 | Facility | None | $8,912.51 | $12,589.25 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $724.44 Median $1,288.25 Typical High $3,715.35 | Professional | None | $724.44 | $1,288.25 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,659.59 Typical High $4,073.80 | Professional | None | $645.65 | $1,659.59 | $4,073.80 |
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 $251.19 Median $436.52 Typical High $1,047.13 | Professional | 52 · Reduced service | $251.19 | $436.52 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $177.83 Typical High $416.87 | Professional | 53 · Discontinued | $100.00 | $177.83 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $660.69 Typical High $1,584.89 | Professional | 54 · Surgery only | $371.54 | $660.69 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $131.83 Typical High $316.23 | Professional | 55 · Aftercare only | $74.13 | $131.83 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $87.10 Typical High $208.93 | Professional | 56 · Pre-op care only | $50.12 | $87.10 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $616.60 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $346.74 | $616.60 | $1,479.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $338.84 Typical High $1,047.13 | Professional | 52 · Reduced service | $251.19 | $338.84 | $1,047.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $134.90 Typical High $416.87 | Professional | 53 · Discontinued | $100.00 | $134.90 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $501.19 Typical High $1,584.89 | Professional | 54 · Surgery only | $371.54 | $501.19 | $1,584.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $100.00 Typical High $316.23 | Professional | 55 · Aftercare only | $74.13 | $100.00 | $316.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $67.61 Typical High $208.93 | Professional | 56 · Pre-op care only | $50.12 | $67.61 | $208.93 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $467.74 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $346.74 | $467.74 | $1,479.11 |
Where Oregon sits
The same service costs 4.9 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· 4th of 51
$2,344
AK $3,020TX $617
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.