How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,862 to $7,943Professionalmedian $3,548 · 10th to 90th $1,862 to $5,129
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 $1,862.09 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,862.09 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,691.53 Typical High $23,988.33 | Facility | None | $758.58 | $2,691.53 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $5,128.61 | Professional | None | $1,949.84 | $3,019.95 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,388.44 Median $3,981.07 Typical High $4,897.79 | Professional | None | $3,388.44 | $3,981.07 | $4,897.79 |
Moda Health Setting Facility Modifier None Typical Low $2,570.40 Median $4,466.84 Typical High $7,943.28 | Facility | None | $2,570.40 | $4,466.84 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,365.16 | Professional | None | $2,454.71 | $3,019.95 | $4,365.16 |
Pacific Source Setting Facility Modifier None Typical Low $2,187.76 Median $3,630.78 Typical High $3,890.45 | Facility | None | $2,187.76 | $3,630.78 | $3,890.45 |
Providence Setting Facility Modifier None Typical Low $2,454.71 Median $251,188.64 Typical High $251,188.64 | Facility | None | $2,454.71 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,548.13 Typical High $5,248.07 | Professional | None | $79.43 | $3,548.13 | $5,248.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Facility | None | $9,772.37 | $9,772.37 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,715.35 Median $3,890.45 Typical High $5,011.87 | Professional | None | $3,715.35 | $3,890.45 | $5,011.87 |
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 $2,187.76 Median $3,467.37 Typical High $5,623.41 | Professional | None | $2,187.76 | $3,467.37 | $5,623.41 |
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 $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,096.48 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $446.68 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,659.59 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $331.13 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,737.80 |
Where Oregon sits
The same service costs 5.9 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· 10th of 51
$3,548
AK $7,762TX $1,318
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.