How much rates vary
Facilitymedian $427 · 10th to 90th $257 to $2,951Professionalmedian $339 · 10th to 90th $178 to $562
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 $309.03 Median $4,786.30 Typical High $7,943.28 | Facility | None | $309.03 | $4,786.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $398.11 | Professional | None | $162.18 | $251.19 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $295.12 Typical High $660.69 | Facility | None | $234.42 | $295.12 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $616.60 | Professional | None | $263.03 | $346.74 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $562.34 | Professional | None | $295.12 | $380.19 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $467.74 Typical High $6,606.93 | Facility | None | $309.03 | $467.74 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $426.58 | Professional | None | $162.18 | $281.84 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $457.09 | Facility | None | $257.04 | $416.87 | $457.09 |
Providence Setting Facility Modifier None Typical Low $239.88 Median $346.74 Typical High $707.95 | Facility | None | $239.88 | $346.74 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $354.81 Typical High $588.84 | Professional | None | $79.43 | $354.81 | $588.84 |
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 $426.58 Typical High $537.03 | Professional | None | $346.74 | $426.58 | $537.03 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $630.96 | Professional | None | $251.19 | $389.05 | $630.96 |
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 $89.13 Median $123.03 Typical High $162.18 | Professional | 52 · Reduced service | $89.13 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $50.12 Typical High $66.07 | Professional | 53 · Discontinued | $35.48 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $134.90 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.12 Typical High $33.11 | Professional | 56 · Pre-op care only | $17.78 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $173.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $125.89 | $173.78 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $123.03 Typical High $162.18 | Professional | 52 · Reduced service | $89.13 | $123.03 | $162.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $50.12 Typical High $66.07 | Professional | 53 · Discontinued | $35.48 | $50.12 | $66.07 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $134.90 | $186.21 | $245.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $48.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.12 Typical High $33.11 | Professional | 56 · Pre-op care only | $17.78 | $25.12 | $33.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $173.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $125.89 | $173.78 | $229.09 |
Where Oregon sits
The same service costs 3.9 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
$363
AK $724KY $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.