How much rates vary
Facilitymedian $100 · 10th to 90th $62 to $224Professionalmedian $89 · 10th to 90th $62 to $145
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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $67.61 Typical High $74.13 | Professional | None | $41.69 | $67.61 | $74.13 |
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 $70.79 Median $87.10 Typical High $144.54 | Professional | None | $70.79 | $87.10 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $128.82 | Professional | None | $77.62 | $100.00 | $128.82 |
Moda Health Setting Facility Modifier None Typical Low $74.13 Median $117.49 Typical High $7,943.28 | Facility | None | $74.13 | $117.49 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $74.13 Typical High $109.65 | Professional | None | $42.66 | $74.13 | $109.65 |
Pacific Source Setting Facility Modifier None Typical Low $60.26 Median $97.72 Typical High $104.71 | Facility | None | $60.26 | $97.72 | $104.71 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $104.71 Typical High $562.34 | Facility | None | $61.66 | $104.71 | $562.34 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $144.54 | Professional | None | $70.79 | $93.33 | $144.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $234.42 | Facility | None | $100.00 | $141.25 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $131.83 | Professional | None | $93.33 | $100.00 | $131.83 |
United Setting Facility Modifier None Typical Low $151.36 Median $257.04 Typical High $4,897.79 | Facility | None | $151.36 | $257.04 | $4,897.79 |
United Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $169.82 | Professional | None | $67.61 | $93.33 | $169.82 |
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 $20.89 Median $33.88 Typical High $36.31 | Professional | 52 · Reduced service | $20.89 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $13.80 Typical High $14.79 | Professional | 53 · Discontinued | $8.51 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $51.29 Typical High $54.95 | Professional | 54 · Surgery only | $31.62 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.23 Typical High $10.96 | Professional | 55 · Aftercare only | $6.31 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.92 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.27 | $6.92 | $7.41 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $47.86 Typical High $51.29 | Professional | 78 · Unplanned return to OR | $29.51 | $47.86 | $51.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $33.88 Typical High $36.31 | Professional | 52 · Reduced service | $19.95 | $33.88 | $36.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $13.80 Typical High $14.79 | Professional | 53 · Discontinued | $8.13 | $13.80 | $14.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $51.29 Typical High $54.95 | Professional | 54 · Surgery only | $30.20 | $51.29 | $54.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $10.23 Typical High $10.96 | Professional | 55 · Aftercare only | $6.03 | $10.23 | $10.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.92 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.07 | $6.92 | $7.41 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.18 Median $47.86 Typical High $51.29 | Professional | 78 · Unplanned return to OR | $28.18 | $47.86 | $51.29 |
Where Oregon sits
The same service costs 4.6 times more in Alaska than in New York. 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· 7th of 51
$93.33
AK $200NY $43.65
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.