How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,413 to $7,943Professionalmedian $2,291 · 10th to 90th $1,230 to $3,548
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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $4,265.80 Typical High $5,888.44 | Facility | None | $870.96 | $4,265.80 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,659.59 | $2,137.96 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,290.87 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,862.09 Median $3,388.44 Typical High $24,547.09 | Facility | None | $1,862.09 | $3,388.44 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,862.09 | $3,162.28 |
Pacific Source Setting Facility Modifier None Typical Low $1,412.54 Median $2,238.72 Typical High $2,454.71 | Facility | None | $1,412.54 | $2,238.72 | $2,454.71 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $3,890.45 Typical High $5,623.41 | Facility | None | $1,023.29 | $3,890.45 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,290.87 Typical High $3,548.13 | Professional | None | $79.43 | $2,290.87 | $3,548.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,589.25 Median $17,378.01 Typical High $19,952.62 | Facility | None | $12,589.25 | $17,378.01 | $19,952.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,344.23 Median $2,454.71 Typical High $3,630.78 | Professional | None | $2,344.23 | $2,454.71 | $3,630.78 |
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 $1,819.70 Median $2,511.89 Typical High $4,168.69 | Professional | None | $1,819.70 | $2,511.89 | $4,168.69 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,000.00 |
Where Oregon sits
The same service costs 7.2 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· 9th of 51
$2,344
AK $4,898TX $676
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.