How much rates vary
Facilitymedian $331 · 10th to 90th $191 to $759Professionalmedian $257 · 10th to 90th $138 to $427
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 $114.82 Median $165.96 Typical High $257.04 | Professional | None | $114.82 | $165.96 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $213.80 Typical High $302.00 | Facility | None | $120.23 | $213.80 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $489.78 | Professional | None | $173.78 | $269.15 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $426.58 | Professional | None | $181.97 | $251.19 | $426.58 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $371.54 Typical High $7,943.28 | Facility | None | $223.87 | $371.54 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $354.81 | Professional | None | $125.89 | $199.53 | $354.81 |
Pacific Source Setting Facility Modifier None Typical Low $204.17 Median $331.13 Typical High $363.08 | Facility | None | $204.17 | $331.13 | $363.08 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $229.09 Typical High $426.58 | Facility | None | $144.54 | $229.09 | $426.58 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $269.15 Typical High $457.09 | Professional | None | $79.43 | $269.15 | $457.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $794.33 Median $1,288.25 Typical High $1,621.81 | Facility | None | $794.33 | $1,288.25 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $371.54 | Professional | None | $223.87 | $338.84 | $371.54 |
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 $173.78 Median $295.12 Typical High $489.78 | Professional | None | $173.78 | $295.12 | $489.78 |
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 $72.44 Median $83.18 Typical High $128.82 | Professional | 52 · Reduced service | $72.44 | $83.18 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $51.29 | Professional | 53 · Discontinued | $28.84 | $33.11 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $123.03 Typical High $194.98 | Professional | 54 · Surgery only | $109.65 | $123.03 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $24.55 Typical High $38.90 | Professional | 55 · Aftercare only | $21.88 | $24.55 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $114.82 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $102.33 | $114.82 | $181.97 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $83.18 Typical High $128.82 | Professional | 52 · Reduced service | $72.44 | $83.18 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $51.29 | Professional | 53 · Discontinued | $28.84 | $33.11 | $51.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $123.03 Typical High $194.98 | Professional | 54 · Surgery only | $109.65 | $123.03 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $24.55 Typical High $38.90 | Professional | 55 · Aftercare only | $21.88 | $24.55 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $25.70 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $114.82 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $102.33 | $114.82 | $181.97 |
Where Oregon sits
The same service costs 3.5 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· 4th of 51
$275
AK $479MD $138
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.