How much rates vary
Facilitymedian $513 · 10th to 90th $251 to $759Professionalmedian $513 · 10th to 90th $302 to $794
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 $436.52 Median $5,011.87 Typical High $7,943.28 | Facility | None | $436.52 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $478.63 | Professional | None | $245.47 | $371.54 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $263.03 Typical High $371.54 | Facility | None | $147.91 | $263.03 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $812.83 | Professional | None | $331.13 | $478.63 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $831.76 | Professional | None | $562.34 | $691.83 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $602.56 Typical High $6,606.93 | Facility | None | $407.38 | $602.56 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $676.08 | Professional | None | $302.00 | $416.87 | $676.08 |
Pacific Source Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $602.56 | Facility | None | $323.59 | $524.81 | $602.56 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $724.44 | Facility | None | $218.78 | $323.59 | $724.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $512.86 Typical High $812.83 | Professional | None | $79.43 | $512.86 | $812.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $954.99 | Facility | None | $645.65 | $812.83 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $741.31 | Professional | None | $524.81 | $575.44 | $741.31 |
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 $323.59 Median $489.78 Typical High $851.14 | Professional | None | $323.59 | $489.78 | $851.14 |
13 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 $162.18 Median $186.21 Typical High $208.93 | Professional | 52 · Reduced service | $162.18 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $245.47 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $263.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $229.09 | $263.03 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | 52 · Reduced service | $186.21 | $186.21 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $83.18 | Professional | 53 · Discontinued | $74.13 | $74.13 | $83.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $281.84 | $281.84 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $41.69 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $41.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $295.12 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Facility | 50 · Both sides | $954.99 | $1,230.27 | $1,445.44 |
Where Oregon sits
The same service costs 5.4 times more in Alaska than in Texas. 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· 9th of 51
$513
AK $1,096TX $204
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.