How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,023 to $9,550Professionalmedian $2,188 · 10th to 90th $1,259 to $3,388
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 $1,621.81 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,621.81 | $1,737.80 | $1,737.80 |
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 $1,288.25 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,288.25 | $2,041.74 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,511.89 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $7,943.28 | Facility | None | $1,584.89 | $2,454.71 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,737.80 | $1,862.09 | $2,691.53 |
Pacific Source Setting Facility Modifier None Typical Low $1,479.11 Median $2,187.76 Typical High $2,511.89 | Facility | None | $1,479.11 | $2,187.76 | $2,511.89 |
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 $2,187.76 Typical High $3,467.37 | Professional | None | $79.43 | $2,187.76 | $3,467.37 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,888.44 Median $9,549.93 Typical High $12,589.25 | Facility | None | $5,888.44 | $9,549.93 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $3,311.31 | Professional | None | $2,398.83 | $2,511.89 | $3,311.31 |
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 $1,445.44 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,445.44 | $2,238.72 | $3,801.89 |
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 $724.44 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $724.44 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $288.40 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,096.48 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $218.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Where Oregon sits
The same service costs 6.5 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
$2,239
AK $5,012TX $776
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.