How much rates vary
Facilitymedian $1,698 · 10th to 90th $891 to $7,943Professionalmedian $1,660 · 10th to 90th $912 to $2,455
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 $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,148.15 | $1,230.27 | $1,230.27 |
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 $933.25 Median $1,479.11 Typical High $2,454.71 | Professional | None | $933.25 | $1,479.11 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,621.81 | $1,905.46 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $7,943.28 | Facility | None | $1,230.27 | $2,041.74 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,445.44 | $2,041.74 |
Pacific Source Setting Facility Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $1,862.09 | Facility | None | $1,071.52 | $1,659.59 | $1,862.09 |
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 $1,698.24 Typical High $2,511.89 | Professional | None | $79.43 | $1,698.24 | $2,511.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $2,398.83 | Professional | None | $1,778.28 | $1,862.09 | $2,398.83 |
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 $1,071.52 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,071.52 | $1,659.59 | $2,754.23 |
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 $537.03 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $213.80 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $162.18 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $107.15 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $912.01 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $851.14 |
Where Oregon sits
The same service costs 24.0 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· 9th of 51
$1,698
AK $3,715TX $155
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.