How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,288 to $6,166Professionalmedian $2,089 · 10th to 90th $1,122 to $3,020
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 $1,412.54 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,412.54 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $4,073.80 Typical High $5,623.41 | Facility | None | $891.25 | $4,073.80 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,819.70 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,238.72 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $3,235.94 Typical High $8,709.64 | Facility | None | $1,513.56 | $3,235.94 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,698.24 | $2,570.40 |
Pacific Source Setting Facility Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $2,238.72 | Facility | None | $1,288.25 | $2,089.30 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $3,715.35 Typical High $5,623.41 | Facility | None | $912.01 | $3,715.35 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,089.30 Typical High $3,090.30 | Professional | None | $79.43 | $2,089.30 | $3,090.30 |
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 $2,137.96 Median $2,238.72 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,238.72 | $2,951.21 |
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 $1,348.96 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,348.96 | $2,041.74 | $3,311.31 |
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 $660.69 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $977.24 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $194.98 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $912.01 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,047.13 |
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
$2,138
AK $4,571UT $741
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.