How much rates vary
Facilitymedian $468 · 10th to 90th $295 to $3,890Professionalmedian $347 · 10th to 90th $182 to $589
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 $302.00 Median $5,623.41 Typical High $8,709.64 | Facility | None | $302.00 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $346.74 | Professional | None | $158.49 | $245.47 | $346.74 |
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 $263.03 Median $354.81 Typical High $630.96 | Professional | None | $263.03 | $354.81 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $588.84 | Professional | None | $302.00 | $398.11 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $7,943.28 | Facility | None | $302.00 | $489.78 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $436.52 | Professional | None | $169.82 | $281.84 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $478.63 | Facility | None | $269.15 | $426.58 | $478.63 |
Providence Setting Facility Modifier None Typical Low $363.08 Median $1,122.02 Typical High $1,905.46 | Facility | None | $363.08 | $1,122.02 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $363.08 Typical High $602.56 | Professional | None | $79.43 | $363.08 | $602.56 |
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 $346.74 Median $457.09 Typical High $549.54 | Professional | None | $346.74 | $457.09 | $549.54 |
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 $263.03 Median $398.11 Typical High $645.65 | Professional | None | $263.03 | $398.11 | $645.65 |
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 $91.20 Median $123.03 Typical High $169.82 | Professional | 52 · Reduced service | $91.20 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $37.15 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $186.21 Typical High $251.19 | Professional | 54 · Surgery only | $138.04 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $37.15 Typical High $50.12 | Professional | 55 · Aftercare only | $27.54 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $24.55 Typical High $33.88 | Professional | 56 · Pre-op care only | $18.20 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $173.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $128.82 | $173.78 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $123.03 Typical High $169.82 | Professional | 52 · Reduced service | $91.20 | $123.03 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $37.15 | $48.98 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $186.21 Typical High $251.19 | Professional | 54 · Surgery only | $138.04 | $186.21 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $37.15 Typical High $50.12 | Professional | 55 · Aftercare only | $27.54 | $37.15 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $24.55 Typical High $33.88 | Professional | 56 · Pre-op care only | $18.20 | $24.55 | $33.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $173.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $128.82 | $173.78 | $234.42 |
Where Oregon sits
The same service costs 4.7 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
$398
AK $871KY $186
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.