How much rates vary
Facilitymedian $1,995 · 10th to 90th $1,202 to $5,012Professionalmedian $1,995 · 10th to 90th $977 to $3,090
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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $2,754.23 Typical High $3,801.89 | Facility | None | $870.96 | $2,754.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,412.54 | $1,819.70 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,187.76 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $7,943.28 | Facility | None | $1,348.96 | $2,290.87 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,621.81 | $2,884.03 |
Pacific Source Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $2,089.30 | Facility | None | $1,174.90 | $1,862.09 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $2,570.40 Typical High $3,630.78 | Facility | None | $1,023.29 | $2,570.40 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,949.84 Typical High $3,090.30 | Professional | None | $79.43 | $1,949.84 | $3,090.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $11,220.18 Typical High $12,882.50 | Facility | None | $7,413.10 | $11,220.18 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,041.74 Median $2,137.96 Typical High $3,162.28 | Professional | None | $2,041.74 | $2,137.96 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $3,630.78 | Professional | None | $1,513.56 | $2,187.76 | $3,630.78 |
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 $676.08 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $676.08 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $933.25 |
Where Oregon sits
The same service costs 6.6 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· 12th of 51
$1,995
AK $4,266TX $646
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.