How much rates vary
Facilitymedian $7,413 · 10th to 90th $2,138 to $9,550Professionalmedian $7,762 · 10th to 90th $3,981 to $11,749
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 $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
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 $5,370.32 Median $6,918.31 Typical High $10,715.19 | Professional | None | $5,370.32 | $6,918.31 | $10,715.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,918.31 Median $7,943.28 Typical High $9,549.93 | Professional | None | $6,918.31 | $7,943.28 | $9,549.93 |
Moda Health Setting Facility Modifier None Typical Low $4,265.80 Median $7,943.28 Typical High $11,220.18 | Facility | None | $4,265.80 | $7,943.28 | $11,220.18 |
Moda Health Setting Professional Modifier None Typical Low $5,128.61 Median $6,309.57 Typical High $10,964.78 | Professional | None | $5,128.61 | $6,309.57 | $10,964.78 |
Pacific Source Setting Facility Modifier None Typical Low $4,677.35 Median $7,413.10 Typical High $8,128.31 | Facility | None | $4,677.35 | $7,413.10 | $8,128.31 |
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 $7,585.78 Typical High $11,748.98 | Professional | None | $79.43 | $7,585.78 | $11,748.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $20,892.96 Median $20,892.96 Typical High $20,892.96 | Facility | None | $20,892.96 | $20,892.96 | $20,892.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $7,762.47 Median $8,128.31 Typical High $12,022.64 | Professional | None | $7,762.47 | $8,128.31 | $12,022.64 |
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 $6,025.60 Median $8,709.64 Typical High $14,125.38 | Professional | None | $6,025.60 | $8,709.64 | $14,125.38 |
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 $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $2,570.40 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,890.45 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $3,630.78 | $3,630.78 | $3,630.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $2,570.40 | $2,570.40 | $2,570.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $1,023.29 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,890.45 | $3,890.45 | $3,890.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $776.25 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $512.86 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $3,630.78 | $3,630.78 | $3,630.78 |
Where Oregon sits
The same service costs 21.4 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
$7,586
AK $16,596TX $776
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.