How much rates vary
Facilitymedian $1,660 · 10th to 90th $955 to $5,129Professionalmedian $1,698 · 10th to 90th $871 to $2,692
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $23,988.33 | Facility | None | $549.54 | $1,000.00 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,548.82 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,698.24 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $7,943.28 | Facility | None | $1,047.13 | $2,089.30 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $2,398.83 | Professional | None | $933.25 | $1,412.54 | $2,398.83 |
Pacific Source Setting Facility Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $1,819.70 | Facility | None | $1,047.13 | $1,659.59 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $251,188.64 Typical High $251,188.64 | Facility | None | $891.25 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,659.59 Typical High $2,691.53 | Professional | None | $79.43 | $1,659.59 | $2,691.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,737.80 | $1,819.70 | $2,691.53 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,862.09 | $3,162.28 |
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 $467.74 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $467.74 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Where Oregon sits
The same service costs 6.6 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· 7th of 51
$1,698
AK $2,884TX $437
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.