How much rates vary
Facilitymedian $209 · 10th to 90th $126 to $741Professionalmedian $158 · 10th to 90th $79 to $302
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 $204.17 Median $5,011.87 Typical High $7,943.28 | Facility | None | $204.17 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $204.17 | Professional | None | $66.07 | $114.82 | $204.17 |
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 $104.71 Median $173.78 Typical High $309.03 | Professional | None | $104.71 | $173.78 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $275.42 | Professional | None | $114.82 | $158.49 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $234.42 Typical High $6,606.93 | Facility | None | $134.90 | $234.42 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $162.18 Typical High $338.84 | Professional | None | $77.62 | $162.18 | $338.84 |
Pacific Source Setting Facility Modifier None Typical Low $125.89 Median $208.93 Typical High $223.87 | Facility | None | $125.89 | $208.93 | $223.87 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $169.82 Typical High $562.34 | Facility | None | $93.33 | $169.82 | $562.34 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $288.40 | Professional | None | $79.43 | $165.96 | $288.40 |
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 $131.83 Median $204.17 Typical High $229.09 | Professional | None | $131.83 | $204.17 | $229.09 |
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 $102.33 Median $177.83 Typical High $309.03 | Professional | None | $102.33 | $177.83 | $309.03 |
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 $45.71 Median $46.77 Typical High $83.18 | Professional | 52 · Reduced service | $45.71 | $46.77 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $33.11 | Professional | 53 · Discontinued | $18.20 | $18.62 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $70.79 Typical High $123.03 | Professional | 54 · Surgery only | $67.61 | $70.79 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $24.55 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $66.07 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $63.10 | $66.07 | $114.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $46.77 Typical High $83.18 | Professional | 52 · Reduced service | $45.71 | $46.77 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $33.11 | Professional | 53 · Discontinued | $18.20 | $18.62 | $33.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $70.79 Typical High $123.03 | Professional | 54 · Surgery only | $67.61 | $70.79 | $123.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $24.55 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $16.60 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $50.12 Median $87.10 Typical High $263.03 | Professional | 59 · Distinct service | $50.12 | $87.10 | $263.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $66.07 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $63.10 | $66.07 | $114.82 |
Where Oregon sits
The same service costs 3.9 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· 4th of 51
$174
AK $309KY $79.43
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.