How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,148 to $7,943Professionalmedian $2,754 · 10th to 90th $1,096 to $4,467
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 $1,096.48 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,905.46 | $1,905.46 |
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 $1,949.84 Median $2,630.27 Typical High $3,981.07 | Professional | None | $1,949.84 | $2,630.27 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,691.53 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,691.53 | $3,090.30 | $3,715.35 |
Moda Health Setting Facility Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $7,943.28 | Facility | None | $1,905.46 | $2,754.23 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $3,981.07 | Professional | None | $1,862.09 | $1,995.26 | $3,981.07 |
Pacific Source Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $3,019.95 | Facility | None | $1,698.24 | $2,511.89 | $3,019.95 |
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 $2,511.89 Typical High $4,466.84 | Professional | None | $79.43 | $2,511.89 | $4,466.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Facility | None | $5,888.44 | $5,888.44 | $5,888.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,884.03 Median $3,019.95 Typical High $4,570.88 | Professional | None | $2,884.03 | $3,019.95 | $4,570.88 |
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 $2,041.74 Median $2,818.38 Typical High $5,248.07 | Professional | None | $2,041.74 | $2,818.38 | $5,248.07 |
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 $831.76 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $831.76 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $331.13 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,258.93 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $251.19 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $165.96 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $954.99 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $389.05 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,348.96 |
Where Oregon sits
The same service costs 8.5 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· 11th of 51
$2,570
AK $6,166TX $724
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.