How much rates vary
Facilitymedian $631 · 10th to 90th $372 to $4,786Professionalmedian $479 · 10th to 90th $240 to $813
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 $446.68 Median $3,890.45 Typical High $7,943.28 | Facility | None | $446.68 | $3,890.45 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $537.03 | Professional | None | $213.80 | $338.84 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,412.54 Typical High $1,905.46 | Facility | None | $812.83 | $1,412.54 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $851.14 | Professional | None | $354.81 | $478.63 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $794.33 | Professional | None | $416.87 | $537.03 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $9,772.37 | Facility | None | $446.68 | $741.31 | $9,772.37 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $741.31 | Professional | None | $229.09 | $416.87 | $741.31 |
Pacific Source Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $954.99 | Facility | None | $363.08 | $588.84 | $954.99 |
Providence Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $1,905.46 | Facility | None | $489.78 | $1,122.02 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $812.83 | Professional | None | $79.43 | $489.78 | $812.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $741.31 | Professional | None | $478.63 | $616.60 | $741.31 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,244.36 | Facility | None | $602.56 | $1,000.00 | $7,244.36 |
United Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $870.96 | Professional | None | $346.74 | $549.54 | $870.96 |
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 $123.03 Median $169.82 Typical High $229.09 | Professional | 52 · Reduced service | $123.03 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $69.18 Typical High $91.20 | Professional | 53 · Discontinued | $48.98 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $257.04 Typical High $338.84 | Professional | 54 · Surgery only | $186.21 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $51.29 Typical High $67.61 | Professional | 55 · Aftercare only | $37.15 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $24.55 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $239.88 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $173.78 | $239.88 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $169.82 Typical High $229.09 | Professional | 52 · Reduced service | $120.23 | $169.82 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $69.18 Typical High $91.20 | Professional | 53 · Discontinued | $47.86 | $69.18 | $91.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $257.04 Typical High $338.84 | Professional | 54 · Surgery only | $181.97 | $257.04 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $51.29 Typical High $67.61 | Professional | 55 · Aftercare only | $36.31 | $51.29 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $23.99 | $33.88 | $45.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $239.88 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $169.82 | $239.88 | $316.23 |
Where Oregon sits
The same service costs 4.8 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
$525
AK $1,202KY $251
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.