How much rates vary
Facilitymedian $331 · 10th to 90th $191 to $741Professionalmedian $240 · 10th to 90th $123 to $437
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 $102.33 Median $162.18 Typical High $288.40 | Professional | None | $102.33 | $162.18 | $288.40 |
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 $162.18 Median $269.15 Typical High $478.63 | Professional | None | $162.18 | $269.15 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $426.58 | Professional | None | $173.78 | $234.42 | $426.58 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $363.08 Typical High $6,606.93 | Facility | None | $213.80 | $363.08 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $218.78 Typical High $489.78 | Professional | None | $112.20 | $218.78 | $489.78 |
Pacific Source Setting Facility Modifier None Typical Low $199.53 Median $323.59 Typical High $363.08 | Facility | None | $199.53 | $323.59 | $363.08 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $281.84 Typical High $478.63 | Facility | None | $100.00 | $281.84 | $478.63 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $263.03 Typical High $446.68 | Professional | None | $79.43 | $263.03 | $446.68 |
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 $208.93 Median $331.13 Typical High $363.08 | Professional | None | $208.93 | $331.13 | $363.08 |
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 $169.82 Median $288.40 Typical High $478.63 | Professional | None | $169.82 | $288.40 | $478.63 |
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 $70.79 Median $75.86 Typical High $128.82 | Professional | 52 · Reduced service | $70.79 | $75.86 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.90 Typical High $51.29 | Professional | 53 · Discontinued | $28.18 | $30.90 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $114.82 Typical High $190.55 | Professional | 54 · Surgery only | $107.15 | $114.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.91 Typical High $38.90 | Professional | 55 · Aftercare only | $21.38 | $22.91 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.49 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.13 | $15.49 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $107.15 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $100.00 | $107.15 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $77.62 Typical High $128.82 | Professional | 52 · Reduced service | $70.79 | $77.62 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.90 Typical High $51.29 | Professional | 53 · Discontinued | $28.18 | $30.90 | $51.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $114.82 Typical High $190.55 | Professional | 54 · Surgery only | $107.15 | $114.82 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.91 Typical High $38.90 | Professional | 55 · Aftercare only | $21.38 | $22.91 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.49 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.13 | $15.49 | $25.70 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $107.15 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $100.00 | $107.15 | $177.83 |
Where Oregon sits
The same service costs 3.4 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
$269
AK $447KY $132
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.