How much rates vary
Facilitymedian $245 · 10th to 90th $151 to $437Professionalmedian $219 · 10th to 90th $112 to $389
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 $181.97 Median $3,235.94 Typical High $6,606.93 | Facility | None | $181.97 | $3,235.94 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $269.15 | Professional | None | $91.20 | $151.36 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $309.03 | Facility | None | $125.89 | $223.87 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $416.87 | Professional | None | $158.49 | $229.09 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $389.05 | Professional | None | $190.55 | $257.04 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $338.84 Typical High $6,165.95 | Facility | None | $186.21 | $338.84 | $6,165.95 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $208.93 Typical High $436.52 | Professional | None | $107.15 | $208.93 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $302.00 | Facility | None | $151.36 | $234.42 | $302.00 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $371.54 | Facility | None | $151.36 | $234.42 | $371.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $229.09 Typical High $380.19 | Professional | None | $79.43 | $229.09 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,621.81 | Facility | None | $954.99 | $1,348.96 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $316.23 | Professional | None | $204.17 | $281.84 | $316.23 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $407.38 | Professional | None | $151.36 | $257.04 | $407.38 |
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 $56.23 Median $74.13 Typical High $109.65 | Professional | 52 · Reduced service | $56.23 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $29.51 Typical High $44.67 | Professional | 53 · Discontinued | $22.39 | $29.51 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $109.65 Typical High $165.96 | Professional | 54 · Surgery only | $83.18 | $109.65 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.88 Typical High $33.11 | Professional | 55 · Aftercare only | $16.60 | $21.88 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.79 Typical High $21.88 | Professional | 56 · Pre-op care only | $11.22 | $14.79 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $102.33 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $77.62 | $102.33 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $74.13 Typical High $109.65 | Professional | 52 · Reduced service | $56.23 | $74.13 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $29.51 Typical High $44.67 | Professional | 53 · Discontinued | $22.39 | $29.51 | $44.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $109.65 Typical High $165.96 | Professional | 54 · Surgery only | $83.18 | $109.65 | $165.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.88 Typical High $33.11 | Professional | 55 · Aftercare only | $16.60 | $21.88 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.79 Typical High $21.88 | Professional | 56 · Pre-op care only | $11.22 | $14.79 | $21.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $102.33 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $77.62 | $102.33 | $154.88 |
Where Oregon sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$229
AK $447KY $110
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.