How much rates vary
Facilitymedian $661 · 10th to 90th $407 to $4,467Professionalmedian $479 · 10th to 90th $257 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 $3,890.45 Median $5,623.41 Typical High $8,709.64 | Facility | None | $3,890.45 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $562.34 | Professional | None | $213.80 | $331.13 | $562.34 |
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 $346.74 Median $501.19 Typical High $891.25 | Professional | None | $346.74 | $501.19 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $812.83 | Professional | None | $371.54 | $501.19 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $7,943.28 | Facility | None | $457.09 | $691.83 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $630.96 | Professional | None | $234.42 | $407.38 | $630.96 |
Pacific Source Setting Facility Modifier None Typical Low $389.05 Median $630.96 Typical High $676.08 | Facility | None | $389.05 | $630.96 | $676.08 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $1,122.02 Typical High $1,905.46 | Facility | None | $512.86 | $1,122.02 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $501.19 Typical High $851.14 | Professional | None | $79.43 | $501.19 | $851.14 |
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 $457.09 Median $630.96 Typical High $707.95 | Professional | None | $457.09 | $630.96 | $707.95 |
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 $575.44 Typical High $912.01 | Professional | None | $346.74 | $575.44 | $912.01 |
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 $134.90 Median $165.96 Typical High $239.88 | Professional | 52 · Reduced service | $134.90 | $165.96 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $66.07 Typical High $97.72 | Professional | 53 · Discontinued | $53.70 | $66.07 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $363.08 | Professional | 54 · Surgery only | $204.17 | $245.47 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $48.98 Typical High $72.44 | Professional | 55 · Aftercare only | $40.74 | $48.98 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.11 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.92 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $229.09 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $190.55 | $229.09 | $338.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $165.96 Typical High $239.88 | Professional | 52 · Reduced service | $134.90 | $165.96 | $239.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $66.07 Typical High $97.72 | Professional | 53 · Discontinued | $53.70 | $66.07 | $97.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $363.08 | Professional | 54 · Surgery only | $204.17 | $245.47 | $363.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $48.98 Typical High $72.44 | Professional | 55 · Aftercare only | $40.74 | $48.98 | $72.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.11 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.92 | $33.11 | $47.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $229.09 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $190.55 | $229.09 | $338.84 |
Where Oregon sits
The same service costs 4.0 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· 4th of 51
$562
AK $1,072KY $269
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.