How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,380 to $7,943Professionalmedian $4,467 · 10th to 90th $2,089 to $6,918
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 $2,290.87 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,290.87 | $3,019.95 | $3,019.95 |
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 $3,162.28 Median $4,073.80 Typical High $6,309.57 | Professional | None | $3,162.28 | $4,073.80 | $6,309.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $5,754.40 | Professional | None | $4,073.80 | $4,786.30 | $5,754.40 |
Moda Health Setting Facility Modifier None Typical Low $3,235.94 Median $5,623.41 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,623.41 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,801.89 Typical High $6,309.57 | Professional | None | $3,019.95 | $3,801.89 | $6,309.57 |
Pacific Source Setting Facility Modifier None Typical Low $2,754.23 Median $4,365.16 Typical High $4,786.30 | Facility | None | $2,754.23 | $4,365.16 | $4,786.30 |
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 $4,365.16 Typical High $6,918.31 | Professional | None | $79.43 | $4,365.16 | $6,918.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Facility | None | $12,302.69 | $12,302.69 | $12,302.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,570.88 Median $4,786.30 Typical High $7,079.46 | Professional | None | $4,570.88 | $4,786.30 | $7,079.46 |
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 $3,467.37 Median $5,011.87 Typical High $8,317.64 | Professional | None | $3,467.37 | $5,011.87 | $8,317.64 |
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,290.87 | $2,290.87 | $2,290.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,137.96 | $2,137.96 |
Where Oregon sits
The same service costs 14.1 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· 8th of 51
$4,467
AK $9,772TX $692
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.