How much rates vary
Facilitymedian $316 · 10th to 90th $151 to $1,288Professionalmedian $209 · 10th to 90th $98 to $398
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 $64.57 Median $131.83 Typical High $257.04 | Professional | None | $64.57 | $131.83 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $457.09 | Professional | None | $138.04 | $251.19 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $398.11 | Professional | None | $165.96 | $223.87 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $354.81 Typical High $6,606.93 | Facility | None | $144.54 | $354.81 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $169.82 Typical High $338.84 | Professional | None | $77.62 | $169.82 | $338.84 |
Pacific Source Setting Facility Modifier None Typical Low $190.55 Median $309.03 Typical High $338.84 | Facility | None | $190.55 | $309.03 | $338.84 |
Providence Setting Facility Modifier None Typical Low $95.50 Median $245.47 Typical High $562.34 | Facility | None | $95.50 | $245.47 | $562.34 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $416.87 | Professional | None | $79.43 | $218.78 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,621.81 | Facility | None | $954.99 | $1,348.96 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $338.84 | Professional | None | $177.83 | $295.12 | $338.84 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $141.25 Median $257.04 Typical High $446.68 | Professional | None | $141.25 | $257.04 | $446.68 |
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 $56.23 Median $66.07 Typical High $123.03 | Professional | 52 · Reduced service | $56.23 | $66.07 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.30 Typical High $50.12 | Professional | 53 · Discontinued | $22.39 | $26.30 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $97.72 Typical High $186.21 | Professional | 54 · Surgery only | $85.11 | $97.72 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.95 Typical High $37.15 | Professional | 55 · Aftercare only | $16.98 | $19.95 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.18 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.22 | $13.18 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $91.20 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $79.43 | $91.20 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $66.07 Typical High $123.03 | Professional | 52 · Reduced service | $56.23 | $66.07 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.30 Typical High $50.12 | Professional | 53 · Discontinued | $22.39 | $26.30 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $97.72 Typical High $186.21 | Professional | 54 · Surgery only | $85.11 | $97.72 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.95 Typical High $37.15 | Professional | 55 · Aftercare only | $16.98 | $19.95 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.18 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.22 | $13.18 | $25.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $91.20 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $79.43 | $91.20 | $173.78 |
Where Oregon sits
The same service costs 4.5 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· 5th of 51
$251
AK $407KY $91.20
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.