How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,660 to $8,318Professionalmedian $2,692 · 10th to 90th $1,445 to $4,074
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $5,128.61 Typical High $6,918.31 | Facility | None | $1,000.00 | $5,128.61 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $3,801.89 | Professional | None | $1,905.46 | $2,511.89 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,344.23 | $2,691.53 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $1,995.26 Median $3,801.89 Typical High $17,378.01 | Facility | None | $1,995.26 | $3,801.89 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $4,168.69 | Professional | None | $1,995.26 | $2,089.30 | $4,168.69 |
Pacific Source Setting Facility Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $2,818.38 | Facility | None | $1,659.59 | $2,754.23 | $2,818.38 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $4,570.88 Typical High $6,918.31 | Facility | None | $1,047.13 | $4,570.88 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,630.27 Typical High $4,073.80 | Professional | None | $79.43 | $2,630.27 | $4,073.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,589.25 Median $18,197.01 Typical High $23,442.29 | Facility | None | $12,589.25 | $18,197.01 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $4,168.69 | Professional | None | $2,691.53 | $2,818.38 | $4,168.69 |
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 $2,089.30 Median $2,951.21 Typical High $4,897.79 | Professional | None | $2,089.30 | $2,951.21 | $4,897.79 |
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $398.11 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Where Oregon sits
The same service costs 5.8 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
$2,754
AK $5,623UT $977
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.