How much rates vary
Facilitymedian $550 · 10th to 90th $316 to $955Professionalmedian $427 · 10th to 90th $224 to $759
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 $338.84 Median $3,235.94 Typical High $6,606.93 | Facility | None | $338.84 | $3,235.94 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $549.54 | Professional | None | $186.21 | $288.40 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $407.38 Typical High $562.34 | Facility | None | $229.09 | $407.38 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $851.14 | Professional | None | $295.12 | $467.74 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $758.58 | Professional | None | $316.23 | $436.52 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $707.95 Typical High $6,606.93 | Facility | None | $354.81 | $707.95 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $707.95 | Professional | None | $199.53 | $363.08 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $346.74 Median $562.34 Typical High $630.96 | Facility | None | $346.74 | $562.34 | $630.96 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $436.52 Typical High $707.95 | Facility | None | $251.19 | $436.52 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $457.09 Typical High $794.33 | Professional | None | $79.43 | $457.09 | $794.33 |
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 $380.19 Median $588.84 Typical High $645.65 | Professional | None | $380.19 | $588.84 | $645.65 |
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 $295.12 Median $501.19 Typical High $851.14 | Professional | None | $295.12 | $501.19 | $851.14 |
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 $125.89 Median $138.04 Typical High $229.09 | Professional | 52 · Reduced service | $125.89 | $138.04 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $91.20 | Professional | 53 · Discontinued | $50.12 | $54.95 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $208.93 Typical High $338.84 | Professional | 54 · Surgery only | $186.21 | $208.93 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $41.69 Typical High $67.61 | Professional | 55 · Aftercare only | $37.15 | $41.69 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $45.71 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $138.04 Typical High $229.09 | Professional | 52 · Reduced service | $125.89 | $138.04 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $91.20 | Professional | 53 · Discontinued | $50.12 | $54.95 | $91.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $208.93 Typical High $338.84 | Professional | 54 · Surgery only | $186.21 | $208.93 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $41.69 Typical High $67.61 | Professional | 55 · Aftercare only | $37.15 | $41.69 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $45.71 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $45.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $316.23 |
Where Oregon sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$468
AK $813MD $219
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.