How much rates vary
Facilitymedian $537 · 10th to 90th $324 to $3,631Professionalmedian $407 · 10th to 90th $245 to $631
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 $245.47 Median $251.19 Typical High $407.38 | Professional | None | $245.47 | $251.19 | $407.38 |
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 $263.03 Median $407.38 Typical High $676.08 | Professional | None | $263.03 | $407.38 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $691.83 | Professional | None | $316.23 | $457.09 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $575.44 Typical High $6,606.93 | Facility | None | $354.81 | $575.44 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $407.38 Typical High $575.44 | Professional | None | $245.47 | $407.38 | $575.44 |
Pacific Source Setting Facility Modifier None Typical Low $316.23 Median $512.86 Typical High $549.54 | Facility | None | $316.23 | $512.86 | $549.54 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $1,122.02 Typical High $1,905.46 | Facility | None | $416.87 | $1,122.02 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $407.38 Typical High $676.08 | Professional | None | $79.43 | $407.38 | $676.08 |
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 $338.84 Median $512.86 Typical High $549.54 | Professional | None | $338.84 | $512.86 | $549.54 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $724.44 | Professional | None | $263.03 | $426.58 | $724.44 |
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 $123.03 Median $123.03 Typical High $199.53 | Professional | 52 · Reduced service | $123.03 | $123.03 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $81.28 | Professional | 53 · Discontinued | $48.98 | $48.98 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $302.00 | Professional | 54 · Surgery only | $186.21 | $186.21 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $60.26 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $40.74 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $123.03 Typical High $199.53 | Professional | 52 · Reduced service | $123.03 | $123.03 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $81.28 | Professional | 53 · Discontinued | $48.98 | $48.98 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $302.00 | Professional | 54 · Surgery only | $186.21 | $186.21 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $60.26 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $40.74 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $40.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $281.84 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,165.95 Median $8,511.38 Typical High $9,772.37 | Facility | 50 · Both sides | $6,165.95 | $8,511.38 | $9,772.37 |
Where Oregon sits
The same service costs 4.1 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· 7th of 51
$427
AK $851TX $209
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.