How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,148 to $7,943Professionalmedian $4,898 · 10th to 90th $2,570 to $7,586
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 $2,570.40 Median $3,311.31 Typical High $3,630.78 | Professional | None | $2,570.40 | $3,311.31 | $3,630.78 |
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 $3,467.37 Median $4,466.84 Typical High $6,918.31 | Professional | None | $3,467.37 | $4,466.84 | $6,918.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,466.84 Median $5,128.61 Typical High $6,165.95 | Professional | None | $4,466.84 | $5,128.61 | $6,165.95 |
Moda Health Setting Facility Modifier None Typical Low $3,630.78 Median $6,025.60 Typical High $7,943.28 | Facility | None | $3,630.78 | $6,025.60 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $3,311.31 Median $4,073.80 Typical High $6,918.31 | Professional | None | $3,311.31 | $4,073.80 | $6,918.31 |
Pacific Source Setting Facility Modifier None Typical Low $3,019.95 Median $4,786.30 Typical High $5,248.07 | Facility | None | $3,019.95 | $4,786.30 | $5,248.07 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,023.29 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $4,786.30 Typical High $7,585.78 | Professional | None | $79.43 | $4,786.30 | $7,585.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $13,489.63 | Facility | None | $13,489.63 | $13,489.63 | $13,489.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,011.87 Median $5,248.07 Typical High $7,762.47 | Professional | None | $5,011.87 | $5,248.07 | $7,762.47 |
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 $3,801.89 Median $5,495.41 Typical High $9,120.11 | Professional | None | $3,801.89 | $5,495.41 | $9,120.11 |
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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,290.87 | $2,290.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,659.59 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,454.71 | $2,454.71 | $2,454.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $331.13 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,290.87 | $2,290.87 |
Where Oregon sits
The same service costs 17.0 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
$4,786
AK $10,471TX $617
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.