How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,318 to $16,596Professionalmedian $2,138 · 10th to 90th $1,122 to $3,311
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 $13,489.63 Typical High $33,884.42 | Facility | None | $5,128.61 | $13,489.63 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,288.25 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $9,549.93 Typical High $13,182.57 | Facility | None | $1,412.54 | $9,549.93 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,949.84 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,819.70 | $2,089.30 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,737.80 Median $3,162.28 Typical High $33,884.42 | Facility | None | $1,737.80 | $3,162.28 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,737.80 | $3,019.95 |
Pacific Source Setting Facility Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $2,238.72 | Facility | None | $1,318.26 | $2,089.30 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $1,318.26 Median $8,912.51 Typical High $13,182.57 | Facility | None | $1,318.26 | $8,912.51 | $13,182.57 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,089.30 Typical High $3,311.31 | Professional | None | $79.43 | $2,089.30 | $3,311.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $25,118.86 Median $35,481.34 Typical High $40,738.03 | Facility | None | $25,118.86 | $35,481.34 | $40,738.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $3,388.44 | Professional | None | $2,137.96 | $2,238.72 | $3,388.44 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $5,128.61 Typical High $25,118.86 | Facility | None | $2,691.53 | $5,128.61 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $3,890.45 | Professional | None | $1,659.59 | $2,344.23 | $3,890.45 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
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 $977.24 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
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 $977.24 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $977.24 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $912.01 |
Where Oregon sits
The same service costs 8.7 times more in Oklahoma 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· 12th of 51
$2,188
OK $6,166TX $708
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.