How much rates vary
Facilitymedian $708 · 10th to 90th $407 to $4,266Professionalmedian $407 · 10th to 90th $204 to $832
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 $251.19 Median $4,786.30 Typical High $7,943.28 | Facility | None | $251.19 | $4,786.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $338.84 Typical High $562.34 | Professional | None | $151.36 | $338.84 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $1,905.46 | Facility | None | $660.69 | $1,412.54 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $407.38 Typical High $891.25 | Professional | None | $213.80 | $407.38 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $933.25 | Professional | None | $288.40 | $407.38 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $794.33 Typical High $6,606.93 | Facility | None | $251.19 | $794.33 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $741.31 | Professional | None | $204.17 | $389.05 | $741.31 |
Pacific Source Setting Facility Modifier None Typical Low $398.11 Median $691.83 Typical High $724.44 | Facility | None | $398.11 | $691.83 | $724.44 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $1,122.02 Typical High $1,905.46 | Facility | None | $354.81 | $1,122.02 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $389.05 Typical High $891.25 | Professional | None | $79.43 | $389.05 | $891.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $724.44 | Professional | None | $281.84 | $501.19 | $724.44 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,244.36 | Facility | None | $602.56 | $1,000.00 | $7,244.36 |
United Setting Professional Modifier None Typical Low $218.78 Median $478.63 Typical High $933.25 | Professional | None | $218.78 | $478.63 | $933.25 |
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 $102.33 Median $104.71 Typical High $281.84 | Professional | 52 · Reduced service | $102.33 | $104.71 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $41.69 Typical High $112.20 | Professional | 53 · Discontinued | $40.74 | $41.69 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $416.87 | Professional | 54 · Surgery only | $154.88 | $154.88 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $83.18 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.89 Typical High $56.23 | Professional | 56 · Pre-op care only | $20.42 | $20.89 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $144.54 | $144.54 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $102.33 Typical High $281.84 | Professional | 52 · Reduced service | $102.33 | $102.33 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $112.20 | Professional | 53 · Discontinued | $40.74 | $40.74 | $112.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $416.87 | Professional | 54 · Surgery only | $154.88 | $154.88 | $416.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $83.18 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $56.23 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $56.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $234.42 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $144.54 | $234.42 | $389.05 |
Where Oregon sits
The same service costs 4.0 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
$525
AK $759KY $191
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.