How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,585 to $10,715Professionalmedian $2,512 · 10th to 90th $1,380 to $3,715
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 $1,584.89 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,584.89 | $1,819.70 | $1,819.70 |
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 $1,412.54 Median $2,238.72 Typical High $3,715.35 | Professional | None | $1,412.54 | $2,238.72 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,344.23 | $2,691.53 | $3,311.31 |
Moda Health Setting Facility Modifier None Typical Low $1,819.70 Median $3,981.07 Typical High $17,378.01 | Facility | None | $1,819.70 | $3,981.07 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,137.96 | $3,162.28 |
Pacific Source Setting Facility Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $2,884.03 | Facility | None | $1,584.89 | $2,511.89 | $2,884.03 |
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 $2,511.89 Typical High $3,715.35 | Professional | None | $79.43 | $2,511.89 | $3,715.35 |
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 $2,630.27 Median $2,754.23 Typical High $3,630.78 | Professional | None | $2,630.27 | $2,754.23 | $3,630.78 |
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 $1,621.81 Median $2,454.71 Typical High $4,073.80 | Professional | None | $1,621.81 | $2,454.71 | $4,073.80 |
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 $794.33 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $794.33 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $323.59 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,202.26 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $239.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $912.01 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
Where Oregon sits
The same service costs 7.2 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· 8th of 51
$2,630
AK $5,495TX $759
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.