How much rates vary
Facilitymedian $537 · 10th to 90th $229 to $708Professionalmedian $550 · 10th to 90th $324 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 $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 $263.03 Median $416.87 Typical High $537.03 | Professional | None | $263.03 | $416.87 | $537.03 |
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 $338.84 Median $524.81 Typical High $870.96 | Professional | None | $338.84 | $524.81 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $870.96 | Professional | None | $588.84 | $741.31 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $660.69 Typical High $7,943.28 | Facility | None | $436.52 | $660.69 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $707.95 | Professional | None | $302.00 | $436.52 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $338.84 Median $562.34 Typical High $630.96 | Facility | None | $338.84 | $562.34 | $630.96 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $758.58 | Facility | None | $218.78 | $323.59 | $758.58 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $870.96 | Professional | None | $79.43 | $562.34 | $870.96 |
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 $575.44 Median $602.56 Typical High $776.25 | Professional | None | $575.44 | $602.56 | $776.25 |
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 $338.84 Median $524.81 Typical High $912.01 | Professional | None | $338.84 | $524.81 | $912.01 |
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 $173.78 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $173.78 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $69.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $309.03 Typical High $323.59 | Professional | 54 · Surgery only | $263.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $41.69 Typical High $43.65 | Professional | 56 · Pre-op care only | $34.67 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $288.40 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $245.47 | $288.40 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $204.17 | $204.17 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $83.18 | $83.18 | $87.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | 54 · Surgery only | $309.03 | $309.03 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $43.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $302.00 |
Where Oregon sits
The same service costs 5.6 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
$537
AK $1,230TX $219
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.