How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,549 to $11,220Professionalmedian $2,455 · 10th to 90th $1,318 to $3,548
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,659.59 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $7,762.47 Typical High $10,715.19 | Facility | None | $1,000.00 | $7,762.47 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $3,630.78 | Professional | None | $1,380.38 | $2,137.96 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $3,162.28 | Professional | None | $2,238.72 | $2,630.27 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $1,778.28 Median $3,801.89 Typical High $17,378.01 | Facility | None | $1,778.28 | $3,801.89 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,778.28 | $2,041.74 | $3,019.95 |
Pacific Source Setting Facility Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $2,691.53 | Facility | None | $1,548.82 | $2,454.71 | $2,691.53 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $7,079.46 Typical High $10,715.19 | Facility | None | $1,047.13 | $7,079.46 | $10,715.19 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,454.71 Typical High $3,630.78 | Professional | None | $79.43 | $2,454.71 | $3,630.78 |
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 $2,511.89 Median $2,691.53 Typical High $3,467.37 | Professional | None | $2,511.89 | $2,691.53 | $3,467.37 |
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 $1,513.56 Median $2,398.83 Typical High $3,890.45 | Professional | None | $1,513.56 | $2,398.83 | $3,890.45 |
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 $776.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $776.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $309.03 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,174.90 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $234.42 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $154.88 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $354.81 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Where Oregon sits
The same service costs 11.0 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· 10th of 51
$2,512
AK $5,370TX $490
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.