How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,622 to $5,495Professionalmedian $4,074 · 10th to 90th $2,138 to $6,310
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 $2,691.53 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,691.53 | $2,754.23 | $2,754.23 |
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 $2,754.23 Median $3,715.35 Typical High $5,754.40 | Professional | None | $2,754.23 | $3,715.35 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,715.35 Median $4,265.80 Typical High $5,248.07 | Professional | None | $3,715.35 | $4,265.80 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $2,754.23 Median $5,011.87 Typical High $7,943.28 | Facility | None | $2,754.23 | $5,011.87 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,754.23 Median $3,388.44 Typical High $5,888.44 | Professional | None | $2,754.23 | $3,388.44 | $5,888.44 |
Pacific Source Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $4,365.16 | Facility | None | $2,511.89 | $3,981.07 | $4,365.16 |
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 $3,981.07 Typical High $6,165.95 | Professional | None | $79.43 | $3,981.07 | $6,165.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Facility | None | $11,220.18 | $11,220.18 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $6,456.54 | Professional | None | $4,168.69 | $4,365.16 | $6,456.54 |
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 $3,162.28 Median $4,365.16 Typical High $7,585.78 | Professional | None | $3,162.28 | $4,365.16 | $7,585.78 |
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 $1,318.26 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,318.26 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $537.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,995.26 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $398.11 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $269.15 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $549.54 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $1,949.84 |
Where Oregon sits
The same service costs 8.1 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· 9th of 51
$4,074
AK $8,913TX $1,096
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.