How much rates vary
Facilitymedian $355 · 10th to 90th $200 to $741Professionalmedian $263 · 10th to 90th $141 to $468
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 $112.20 Median $169.82 Typical High $288.40 | Professional | None | $112.20 | $169.82 | $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 $181.97 Median $288.40 Typical High $524.81 | Professional | None | $181.97 | $288.40 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $457.09 | Professional | None | $190.55 | $257.04 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $398.11 Typical High $7,943.28 | Facility | None | $239.88 | $398.11 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $407.38 | Professional | None | $131.83 | $223.87 | $407.38 |
Pacific Source Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $389.05 | Facility | None | $218.78 | $354.81 | $389.05 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $309.03 Typical High $524.81 | Facility | None | $100.00 | $309.03 | $524.81 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $288.40 Typical High $489.78 | Professional | None | $79.43 | $288.40 | $489.78 |
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 $234.42 Median $363.08 Typical High $398.11 | Professional | None | $234.42 | $363.08 | $398.11 |
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 $181.97 Median $316.23 Typical High $524.81 | Professional | None | $181.97 | $316.23 | $524.81 |
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 $77.62 Median $85.11 Typical High $138.04 | Professional | 52 · Reduced service | $77.62 | $85.11 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $54.95 | Professional | 53 · Discontinued | $31.62 | $33.88 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $128.82 Typical High $208.93 | Professional | 54 · Surgery only | $117.49 | $128.82 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $25.70 Typical High $41.69 | Professional | 55 · Aftercare only | $23.44 | $25.70 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.98 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.49 | $16.98 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $120.23 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $109.65 | $120.23 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $85.11 Typical High $138.04 | Professional | 52 · Reduced service | $77.62 | $85.11 | $138.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $54.95 | Professional | 53 · Discontinued | $31.62 | $33.88 | $54.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $128.82 Typical High $208.93 | Professional | 54 · Surgery only | $117.49 | $128.82 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $25.70 Typical High $41.69 | Professional | 55 · Aftercare only | $23.44 | $25.70 | $41.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.98 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.49 | $16.98 | $27.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $120.23 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $109.65 | $120.23 | $194.98 |
Where Oregon sits
The same service costs 3.3 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· 5th of 51
$288
AK $490MD $148
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.