How much rates vary
Facilitymedian $427 · 10th to 90th $200 to $589Professionalmedian $339 · 10th to 90th $186 to $575
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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $346.74 | Professional | None | $186.21 | $186.21 | $346.74 |
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 $199.53 Median $338.84 Typical High $616.60 | Professional | None | $199.53 | $338.84 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $562.34 | Professional | None | $229.09 | $295.12 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $7,943.28 | Facility | None | $229.09 | $398.11 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $346.74 Typical High $457.09 | Professional | None | $186.21 | $346.74 | $457.09 |
Pacific Source Setting Facility Modifier None Typical Low $263.03 Median $426.58 Typical High $467.74 | Facility | None | $263.03 | $426.58 | $467.74 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $380.19 Typical High $676.08 | Facility | None | $100.00 | $380.19 | $676.08 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $331.13 Typical High $588.84 | Professional | None | $79.43 | $331.13 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $794.33 | Facility | None | $524.81 | $691.83 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $467.74 | Professional | None | $257.04 | $416.87 | $467.74 |
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 $204.17 Median $371.54 Typical High $616.60 | Professional | None | $204.17 | $371.54 | $616.60 |
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 $93.33 Median $93.33 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $93.33 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $37.15 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $257.04 | Professional | 54 · Surgery only | $138.04 | $138.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $51.29 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $93.33 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $93.33 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $37.15 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $257.04 | Professional | 54 · Surgery only | $138.04 | $138.04 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $51.29 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $34.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $239.88 |
Where Oregon sits
The same service costs 3.8 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
$372
AK $603MD $158
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.