How much rates vary
Facilitymedian $525 · 10th to 90th $302 to $4,266Professionalmedian $380 · 10th to 90th $219 to $603
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 $162.18 Median $229.09 Typical High $398.11 | Professional | None | $162.18 | $229.09 | $398.11 |
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 $229.09 Median $389.05 Typical High $660.69 | Professional | None | $229.09 | $389.05 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $691.83 | Professional | None | $288.40 | $416.87 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $316.23 Median $645.65 Typical High $7,943.28 | Facility | None | $316.23 | $645.65 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $549.54 | Professional | None | $218.78 | $346.74 | $549.54 |
Pacific Source Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $537.03 | Facility | None | $302.00 | $489.78 | $537.03 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $1,122.02 Typical High $1,905.46 | Facility | None | $380.19 | $1,122.02 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $389.05 Typical High $660.69 | Professional | None | $79.43 | $389.05 | $660.69 |
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 $302.00 Median $489.78 Typical High $537.03 | Professional | None | $302.00 | $489.78 | $537.03 |
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 $229.09 Median $389.05 Typical High $691.83 | Professional | None | $229.09 | $389.05 | $691.83 |
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 $109.65 Median $112.20 Typical High $199.53 | Professional | 52 · Reduced service | $109.65 | $112.20 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $44.67 Typical High $79.43 | Professional | 53 · Discontinued | $43.65 | $44.67 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $295.12 | Professional | 54 · Surgery only | $165.96 | $165.96 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $58.88 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.39 Typical High $39.81 | Professional | 56 · Pre-op care only | $21.88 | $22.39 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $109.65 Typical High $199.53 | Professional | 52 · Reduced service | $109.65 | $109.65 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $79.43 | Professional | 53 · Discontinued | $43.65 | $43.65 | $79.43 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $295.12 | Professional | 54 · Surgery only | $165.96 | $165.96 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $58.88 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $39.81 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $275.42 |
Where Oregon sits
The same service costs 4.5 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· 6th of 51
$398
AK $759KY $170
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.