How much rates vary
Facilitymedian $1,862 · 10th to 90th $977 to $5,248Professionalmedian $1,905 · 10th to 90th $1,047 to $2,951
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 $1,258.93 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,258.93 | $1,412.54 | $1,412.54 |
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 $1,122.02 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,122.02 | $1,778.28 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,884.03 | Professional | None | $1,995.26 | $2,344.23 | $2,884.03 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $7,943.28 | Facility | None | $1,412.54 | $2,041.74 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,412.54 | $2,511.89 |
Pacific Source Setting Facility Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,187.76 | Facility | None | $1,258.93 | $1,819.70 | $2,187.76 |
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 $1,778.28 Typical High $2,951.21 | Professional | None | $79.43 | $1,778.28 | $2,951.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,884.03 | Professional | None | $2,137.96 | $2,238.72 | $2,884.03 |
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 $1,230.27 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,949.84 | $3,235.94 |
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 $602.56 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $239.88 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,000.00 |
Where Oregon sits
The same service costs 21.9 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
$1,905
AK $4,467TX $204
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.