How much rates vary
Facilitymedian $550 · 10th to 90th $324 to $2,951Professionalmedian $437 · 10th to 90th $229 to $708
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $436.52 | Professional | None | $204.17 | $316.23 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $1,905.46 | Facility | None | $660.69 | $1,412.54 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $758.58 | Professional | None | $331.13 | $436.52 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $691.83 | Professional | None | $371.54 | $478.63 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $630.96 Typical High $6,606.93 | Facility | None | $407.38 | $630.96 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $549.54 | Professional | None | $213.80 | $363.08 | $549.54 |
Pacific Source Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $575.44 | Facility | None | $323.59 | $524.81 | $575.44 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $1,122.02 Typical High $1,905.46 | Facility | None | $426.58 | $1,122.02 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $457.09 Typical High $741.31 | Professional | None | $79.43 | $457.09 | $741.31 |
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 $436.52 Median $524.81 Typical High $676.08 | Professional | None | $436.52 | $524.81 | $676.08 |
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 $316.23 Median $489.78 Typical High $794.33 | Professional | None | $316.23 | $489.78 | $794.33 |
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 $112.20 Median $158.49 Typical High $204.17 | Professional | 52 · Reduced service | $112.20 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $63.10 Typical High $81.28 | Professional | 53 · Discontinued | $44.67 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $234.42 Typical High $302.00 | Professional | 54 · Surgery only | $165.96 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $46.77 Typical High $61.66 | Professional | 55 · Aftercare only | $33.11 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $31.62 Typical High $40.74 | Professional | 56 · Pre-op care only | $22.39 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $218.78 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $154.88 | $218.78 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $158.49 Typical High $204.17 | Professional | 52 · Reduced service | $112.20 | $158.49 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $63.10 Typical High $81.28 | Professional | 53 · Discontinued | $44.67 | $63.10 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $234.42 Typical High $302.00 | Professional | 54 · Surgery only | $165.96 | $234.42 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $46.77 Typical High $61.66 | Professional | 55 · Aftercare only | $33.11 | $46.77 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $31.62 Typical High $40.74 | Professional | 56 · Pre-op care only | $22.39 | $31.62 | $40.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $218.78 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $154.88 | $218.78 | $281.84 |
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
$479
AK $912KY $234
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.