How much rates vary
Facilitymedian $479 · 10th to 90th $263 to $724Professionalmedian $447 · 10th to 90th $275 to $692
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 $234.42 Median $323.59 Typical High $371.54 | Professional | None | $234.42 | $323.59 | $371.54 |
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 $288.40 Median $426.58 Typical High $707.95 | Professional | None | $288.40 | $426.58 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $691.83 | Professional | None | $457.09 | $562.34 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $616.60 Typical High $6,606.93 | Facility | None | $407.38 | $616.60 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $562.34 | Professional | None | $281.84 | $371.54 | $562.34 |
Pacific Source Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $524.81 | Facility | None | $302.00 | $489.78 | $524.81 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $630.96 | Facility | None | $218.78 | $323.59 | $630.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $446.68 Typical High $707.95 | Professional | None | $79.43 | $446.68 | $707.95 |
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 $446.68 Median $512.86 Typical High $645.65 | Professional | None | $446.68 | $512.86 | $645.65 |
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 $302.00 Median $446.68 Typical High $758.58 | Professional | None | $302.00 | $446.68 | $758.58 |
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 $147.91 Median $162.18 Typical High $186.21 | Professional | 52 · Reduced service | $147.91 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $74.13 | Professional | 53 · Discontinued | $58.88 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $239.88 Typical High $275.42 | Professional | 54 · Surgery only | $218.78 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $48.98 Typical High $54.95 | Professional | 55 · Aftercare only | $43.65 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $37.15 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $223.87 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $204.17 | $223.87 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 52 · Reduced service | $162.18 | $162.18 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $74.13 | Professional | 53 · Discontinued | $64.57 | $64.57 | $74.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $275.42 | Professional | 54 · Surgery only | $239.88 | $239.88 | $275.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $54.95 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $37.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $257.04 |
Where Oregon sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$447
AK $955UT $186
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.