How much rates vary
Facilitymedian $234 · 10th to 90th $141 to $525Professionalmedian $186 · 10th to 90th $117 to $309
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 $95.50 Median $128.82 Typical High $173.78 | Professional | None | $95.50 | $128.82 | $173.78 |
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 $134.90 Median $186.21 Typical High $331.13 | Professional | None | $134.90 | $186.21 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $295.12 | Professional | None | $144.54 | $194.98 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $7,943.28 | Facility | None | $173.78 | $251.19 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $245.47 | Professional | None | $107.15 | $173.78 | $245.47 |
Pacific Source Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $251.19 | Facility | None | $141.25 | $229.09 | $251.19 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $234.42 Typical High $562.34 | Facility | None | $100.00 | $234.42 | $562.34 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $316.23 | Professional | None | $79.43 | $194.98 | $316.23 |
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 $177.83 Median $229.09 Typical High $275.42 | Professional | None | $177.83 | $229.09 | $275.42 |
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 $134.90 Median $208.93 Typical High $338.84 | Professional | None | $134.90 | $208.93 | $338.84 |
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 $53.70 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $53.70 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $21.38 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $95.50 Typical High $131.83 | Professional | 54 · Surgery only | $81.28 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.05 Typical High $26.30 | Professional | 55 · Aftercare only | $16.22 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $89.13 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $75.86 | $89.13 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $53.70 | $64.57 | $87.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $21.38 | $25.70 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $95.50 Typical High $131.83 | Professional | 54 · Surgery only | $81.28 | $95.50 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.05 Typical High $26.30 | Professional | 55 · Aftercare only | $16.22 | $19.05 | $26.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $17.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $89.13 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $75.86 | $89.13 | $123.03 |
Where Oregon sits
The same service costs 3.8 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· 6th of 51
$204
AK $380NY $100
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.