How much rates vary
Facilitymedian $182 · 10th to 90th $110 to $741Professionalmedian $141 · 10th to 90th $79 to $245
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $162.18 | Professional | None | $63.10 | $97.72 | $162.18 |
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 $147.91 Typical High $269.15 | Professional | None | $104.71 | $147.91 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $234.42 | Professional | None | $109.65 | $147.91 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $138.04 Median $204.17 Typical High $6,606.93 | Facility | None | $138.04 | $204.17 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $229.09 | Professional | None | $74.13 | $123.03 | $229.09 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $181.97 Typical High $194.98 | Facility | None | $109.65 | $181.97 | $194.98 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $169.82 Typical High $257.04 | Facility | None | $87.10 | $169.82 | $257.04 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $251.19 | Professional | None | $79.43 | $147.91 | $251.19 |
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 $134.90 Median $186.21 Typical High $208.93 | Professional | None | $134.90 | $186.21 | $208.93 |
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 $165.96 Typical High $269.15 | Professional | None | $102.33 | $165.96 | $269.15 |
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 $38.90 Median $48.98 Typical High $70.79 | Professional | 52 · Reduced service | $38.90 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.95 Typical High $28.18 | Professional | 53 · Discontinued | $15.49 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $74.13 Typical High $107.15 | Professional | 54 · Surgery only | $57.54 | $74.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.79 Typical High $21.38 | Professional | 55 · Aftercare only | $11.75 | $14.79 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.77 Typical High $14.13 | Professional | 56 · Pre-op care only | $7.76 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $69.18 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $53.70 | $69.18 | $100.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $48.98 Typical High $70.79 | Professional | 52 · Reduced service | $38.90 | $48.98 | $70.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.95 Typical High $28.18 | Professional | 53 · Discontinued | $15.49 | $19.95 | $28.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $74.13 Typical High $107.15 | Professional | 54 · Surgery only | $57.54 | $74.13 | $107.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.79 Typical High $21.38 | Professional | 55 · Aftercare only | $11.75 | $14.79 | $21.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.77 Typical High $14.13 | Professional | 56 · Pre-op care only | $7.76 | $9.77 | $14.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $69.18 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $53.70 | $69.18 | $100.00 |
Where Oregon sits
The same service costs 3.8 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
$155
AK $288KY $75.86
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.