How much rates vary
Facilitymedian $537 · 10th to 90th $324 to $4,786Professionalmedian $427 · 10th to 90th $245 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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $426.58 | Professional | None | $186.21 | $269.15 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $371.54 Typical High $512.86 | Facility | None | $208.93 | $371.54 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $776.25 | Professional | None | $275.42 | $426.58 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $707.95 | Professional | None | $323.59 | $436.52 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $380.19 Median $616.60 Typical High $7,943.28 | Facility | None | $380.19 | $616.60 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $602.56 | Professional | None | $218.78 | $380.19 | $602.56 |
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 $251.19 Median $389.05 Typical High $676.08 | Facility | None | $251.19 | $389.05 | $676.08 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $426.58 Typical High $724.44 | Professional | None | $79.43 | $426.58 | $724.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $7,413.10 | Facility | None | $4,786.30 | $6,456.54 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $602.56 | Professional | None | $354.81 | $537.03 | $602.56 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $794.33 | Professional | None | $281.84 | $478.63 | $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 $109.65 Median $134.90 Typical High $213.80 | Professional | 52 · Reduced service | $109.65 | $134.90 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $53.70 Typical High $85.11 | Professional | 53 · Discontinued | $43.65 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $165.96 | $199.53 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $39.81 Typical High $64.57 | Professional | 55 · Aftercare only | $33.11 | $39.81 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $26.92 Typical High $42.66 | Professional | 56 · Pre-op care only | $21.88 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $186.21 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $154.88 | $186.21 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $134.90 Typical High $213.80 | Professional | 52 · Reduced service | $109.65 | $134.90 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $53.70 Typical High $85.11 | Professional | 53 · Discontinued | $43.65 | $53.70 | $85.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $165.96 | $199.53 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $39.81 Typical High $64.57 | Professional | 55 · Aftercare only | $33.11 | $39.81 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $26.92 Typical High $42.66 | Professional | 56 · Pre-op care only | $21.88 | $26.92 | $42.66 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $186.21 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $154.88 | $186.21 | $302.00 |
Where Oregon sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 6th of 51
$468
AK $759TX $214
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.