How much rates vary
Facilitymedian $129 · 10th to 90th $78 to $661Professionalmedian $102 · 10th to 90th $66 to $174
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 $107.15 Median $3,235.94 Typical High $6,606.93 | Facility | None | $107.15 | $3,235.94 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $83.18 Typical High $123.03 | Professional | None | $51.29 | $83.18 | $123.03 |
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 $81.28 Median $107.15 Typical High $186.21 | Professional | None | $81.28 | $107.15 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $162.18 | Professional | None | $89.13 | $117.49 | $162.18 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $6,606.93 | Facility | None | $95.50 | $154.88 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $169.82 | Professional | None | $58.88 | $91.20 | $169.82 |
Pacific Source Setting Facility Modifier None Typical Low $74.13 Median $125.89 Typical High $138.04 | Facility | None | $74.13 | $125.89 | $138.04 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $128.82 Typical High $562.34 | Facility | None | $70.79 | $128.82 | $562.34 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $177.83 | Professional | None | $79.43 | $112.20 | $177.83 |
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 $104.71 Median $128.82 Typical High $165.96 | Professional | None | $104.71 | $128.82 | $165.96 |
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 $77.62 Median $112.20 Typical High $190.55 | Professional | None | $77.62 | $112.20 | $190.55 |
13 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 $33.11 Median $38.02 Typical High $47.86 | Professional | 52 · Reduced service | $33.11 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $15.14 Typical High $19.05 | Professional | 53 · Discontinued | $13.18 | $15.14 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $57.54 Typical High $70.79 | Professional | 54 · Surgery only | $50.12 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.48 Typical High $14.13 | Professional | 55 · Aftercare only | $10.00 | $11.48 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.59 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.61 | $7.59 | $9.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $53.70 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $46.77 | $53.70 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $38.02 Typical High $47.86 | Professional | 52 · Reduced service | $33.11 | $38.02 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $15.14 Typical High $19.05 | Professional | 53 · Discontinued | $13.18 | $15.14 | $19.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $57.54 Typical High $70.79 | Professional | 54 · Surgery only | $50.12 | $57.54 | $70.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.48 Typical High $14.13 | Professional | 55 · Aftercare only | $10.00 | $11.48 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.59 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.61 | $7.59 | $9.55 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $26.30 Median $54.95 Typical High $181.97 | Professional | 59 · Distinct service | $26.30 | $54.95 | $181.97 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $53.70 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $46.77 | $53.70 | $66.07 |
Where Oregon sits
The same service costs 4.2 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· 6th of 51
$112
AK $224KY $53.70
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.