How much rates vary
Facilitymedian $2,042 · 10th to 90th $1,230 to $14,454Professionalmedian $1,905 · 10th to 90th $1,047 to $2,818
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $12,302.69 Typical High $16,982.44 | Facility | None | $891.25 | $12,302.69 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,096.48 | $1,737.80 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,778.28 | $2,089.30 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $1,479.11 Median $3,019.95 Typical High $8,709.64 | Facility | None | $1,479.11 | $3,019.95 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,621.81 | $2,398.83 |
Pacific Source Setting Facility Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $2,137.96 | Facility | None | $1,230.27 | $1,949.84 | $2,137.96 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $11,220.18 Typical High $16,982.44 | Facility | None | $912.01 | $11,220.18 | $16,982.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,949.84 Typical High $2,884.03 | Professional | None | $79.43 | $1,949.84 | $2,884.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $15,488.17 Median $22,387.21 Typical High $26,302.68 | Facility | None | $15,488.17 | $22,387.21 | $26,302.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,995.26 | $2,137.96 | $2,754.23 |
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 $1,230.27 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,230.27 | $1,905.46 | $3,090.30 |
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 $616.60 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $616.60 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $186.21 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $123.03 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $977.24 | $977.24 |
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 $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,047.13 |
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 $977.24 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $977.24 |
Where Oregon sits
The same service costs 6.2 times more in Alaska than in Utah. 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· 8th of 51
$1,995
AK $4,266UT $692
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.