How much rates vary
Facilitymedian $631 · 10th to 90th $324 to $1,122Professionalmedian $550 · 10th to 90th $288 to $933
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 $371.54 Median $5,128.61 Typical High $8,709.64 | Facility | None | $371.54 | $5,128.61 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $691.83 | Professional | None | $223.87 | $331.13 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $467.74 Typical High $891.25 | Facility | None | $363.08 | $467.74 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $1,023.29 | Professional | None | $316.23 | $562.34 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $954.99 | Professional | None | $371.54 | $489.78 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $7,943.28 | Facility | None | $371.54 | $794.33 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $741.31 | Professional | None | $239.88 | $426.58 | $741.31 |
Pacific Source Setting Facility Modifier None Typical Low $398.11 Median $676.08 Typical High $776.25 | Facility | None | $398.11 | $676.08 | $776.25 |
Providence Setting Facility Modifier None Typical Low $363.08 Median $537.03 Typical High $1,000.00 | Facility | None | $363.08 | $537.03 | $1,000.00 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $977.24 | Professional | None | $79.43 | $524.81 | $977.24 |
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 $416.87 Median $707.95 Typical High $776.25 | Professional | None | $416.87 | $707.95 | $776.25 |
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 $338.84 Median $588.84 Typical High $1,023.29 | Professional | None | $338.84 | $588.84 | $1,023.29 |
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 $144.54 Median $151.36 Typical High $281.84 | Professional | 52 · Reduced service | $144.54 | $151.36 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $60.26 Typical High $112.20 | Professional | 53 · Discontinued | $58.88 | $60.26 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $223.87 Typical High $416.87 | Professional | 54 · Surgery only | $218.78 | $223.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $44.67 Typical High $83.18 | Professional | 55 · Aftercare only | $43.65 | $44.67 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $56.23 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $208.93 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $204.17 | $208.93 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $151.36 Typical High $281.84 | Professional | 52 · Reduced service | $144.54 | $151.36 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $60.26 Typical High $112.20 | Professional | 53 · Discontinued | $58.88 | $60.26 | $112.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $223.87 Typical High $416.87 | Professional | 54 · Surgery only | $218.78 | $223.87 | $416.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $44.67 Typical High $83.18 | Professional | 55 · Aftercare only | $43.65 | $44.67 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $56.23 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $56.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $208.93 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $204.17 | $208.93 | $389.05 |
Where Oregon sits
The same service costs 3.5 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
$562
AK $891MD $257
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.