How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,148 to $7,943Professionalmedian $4,786 · 10th to 90th $2,512 to $7,413
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 $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
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 $3,388.44 Median $4,365.16 Typical High $6,606.93 | Professional | None | $3,388.44 | $4,365.16 | $6,606.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,365.16 Median $5,011.87 Typical High $6,025.60 | Professional | None | $4,365.16 | $5,011.87 | $6,025.60 |
Moda Health Setting Facility Modifier None Typical Low $3,467.37 Median $5,888.44 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,888.44 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,981.07 Typical High $6,918.31 | Professional | None | $3,235.94 | $3,981.07 | $6,918.31 |
Pacific Source Setting Facility Modifier None Typical Low $2,884.03 Median $4,466.84 Typical High $5,011.87 | Facility | None | $2,884.03 | $4,466.84 | $5,011.87 |
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 $4,677.35 Typical High $7,413.10 | Professional | None | $79.43 | $4,677.35 | $7,413.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Facility | None | $10,964.78 | $10,964.78 | $10,964.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $7,585.78 | Professional | None | $4,897.79 | $5,128.61 | $7,585.78 |
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 $3,715.35 Median $5,128.61 Typical High $8,709.64 | Professional | None | $3,715.35 | $5,128.61 | $8,709.64 |
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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,621.81 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $645.65 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $323.59 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $2,238.72 |
Where Oregon sits
The same service costs 10.0 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· 8th of 51
$4,677
AK $10,233TX $1,023
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.