How much rates vary
Facilitymedian $269 · 10th to 90th $158 to $776Professionalmedian $219 · 10th to 90th $102 to $372
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 $4,677.35 Typical High $7,943.28 | Facility | None | $181.97 | $4,677.35 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $275.42 | Professional | None | $97.72 | $154.88 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $223.87 Typical High $660.69 | Facility | None | $177.83 | $223.87 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $426.58 | Professional | None | $158.49 | $234.42 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $380.19 | Professional | None | $173.78 | $239.88 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $6,606.93 | Facility | None | $181.97 | $302.00 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $186.21 Typical High $371.54 | Professional | None | $93.33 | $186.21 | $371.54 |
Pacific Source Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $309.03 | Facility | None | $158.49 | $257.04 | $309.03 |
Providence Setting Facility Modifier None Typical Low $177.83 Median $239.88 Typical High $707.95 | Facility | None | $177.83 | $239.88 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $234.42 Typical High $398.11 | Professional | None | $79.43 | $234.42 | $398.11 |
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 $288.40 Typical High $323.59 | Professional | None | $204.17 | $288.40 | $323.59 |
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 $158.49 Median $257.04 Typical High $426.58 | Professional | None | $158.49 | $257.04 | $426.58 |
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 $58.88 Median $74.13 Typical High $112.20 | Professional | 52 · Reduced service | $58.88 | $74.13 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $29.51 Typical High $45.71 | Professional | 53 · Discontinued | $23.44 | $29.51 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $109.65 Typical High $169.82 | Professional | 54 · Surgery only | $89.13 | $109.65 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.39 Typical High $33.88 | Professional | 55 · Aftercare only | $17.78 | $22.39 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.79 Typical High $22.39 | Professional | 56 · Pre-op care only | $11.75 | $14.79 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $102.33 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $83.18 | $102.33 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $74.13 Typical High $112.20 | Professional | 52 · Reduced service | $58.88 | $74.13 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $29.51 Typical High $45.71 | Professional | 53 · Discontinued | $23.44 | $29.51 | $45.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $109.65 Typical High $169.82 | Professional | 54 · Surgery only | $89.13 | $109.65 | $169.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.39 Typical High $33.88 | Professional | 55 · Aftercare only | $17.78 | $22.39 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.79 Typical High $22.39 | Professional | 56 · Pre-op care only | $11.75 | $14.79 | $22.39 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $102.33 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $83.18 | $102.33 | $158.49 |
Where Oregon sits
The same service costs 3.7 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· 7th of 51
$229
AK $427KY $115
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.