How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,549 to $10,233Professionalmedian $2,512 · 10th to 90th $1,318 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 $5,128.61 Median $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $6,025.60 Typical High $8,317.64 | Facility | None | $870.96 | $6,025.60 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,290.87 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,454.71 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $2,041.74 Median $3,630.78 Typical High $24,547.09 | Facility | None | $2,041.74 | $3,630.78 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,995.26 | $3,467.37 |
Pacific Source Setting Facility Modifier None Typical Low $1,548.82 Median $2,511.89 Typical High $2,630.27 | Facility | None | $1,548.82 | $2,511.89 | $2,630.27 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $5,495.41 Typical High $7,943.28 | Facility | None | $1,023.29 | $5,495.41 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,454.71 Typical High $3,801.89 | Professional | None | $79.43 | $2,454.71 | $3,801.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $19,952.62 Median $26,302.68 Typical High $30,199.52 | Facility | None | $19,952.62 | $26,302.68 | $30,199.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $3,890.45 | Professional | None | $2,511.89 | $2,630.27 | $3,890.45 |
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 $1,949.84 Median $2,691.53 Typical High $4,570.88 | Professional | None | $1,949.84 | $2,691.53 | $4,570.88 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,071.52 |
Where Oregon sits
The same service costs 6.9 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· 11th of 51
$2,512
AK $5,370TX $776
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.