How much rates vary
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 $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
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 $2,691.53 Median $3,467.37 Typical High $5,370.32 | Professional | None | $2,691.53 | $3,467.37 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,548.13 Median $4,073.80 Typical High $4,897.79 | Professional | None | $3,548.13 | $4,073.80 | $4,897.79 |
Moda Health Setting Facility Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $7,943.28 | Facility | None | $2,691.53 | $4,677.35 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $5,495.41 | Professional | None | $2,570.40 | $3,235.94 | $5,495.41 |
Pacific Source Setting Facility Modifier None Typical Low $2,290.87 Median $3,548.13 Typical High $3,981.07 | Facility | None | $2,290.87 | $3,548.13 | $3,981.07 |
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 $3,715.35 Typical High $5,888.44 | Professional | None | $79.43 | $3,715.35 | $5,888.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $10,471.29 | Facility | None | $10,471.29 | $10,471.29 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,890.45 Median $4,073.80 Typical High $6,025.60 | Professional | None | $3,890.45 | $4,073.80 | $6,025.60 |
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 $2,951.21 Median $4,265.80 Typical High $7,079.46 | Professional | None | $2,951.21 | $4,265.80 | $7,079.46 |
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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $512.86 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $1,778.28 |
Where Oregon sits
The same service costs 7.8 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
$3,802
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.