How much rates vary
Facilitymedian $234 · 10th to 90th $141 to $724Professionalmedian $229 · 10th to 90th $132 to $339
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 $109.65 Median $173.78 Typical High $173.78 | Professional | None | $109.65 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $173.78 Typical High $239.88 | Facility | None | $97.72 | $173.78 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $363.08 | Professional | None | $144.54 | $223.87 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $346.74 | Professional | None | $245.47 | $302.00 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $331.13 Typical High $6,606.93 | Facility | None | $190.55 | $331.13 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $263.03 | Professional | None | $128.82 | $173.78 | $263.03 |
Pacific Source Setting Facility Modifier None Typical Low $141.25 Median $234.42 Typical High $251.19 | Facility | None | $141.25 | $234.42 | $251.19 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $194.98 Typical High $331.13 | Facility | None | $144.54 | $194.98 | $331.13 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $234.42 Typical High $363.08 | Professional | None | $79.43 | $234.42 | $363.08 |
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 $239.88 Median $251.19 Typical High $309.03 | Professional | None | $239.88 | $251.19 | $309.03 |
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 $138.04 Median $213.80 Typical High $346.74 | Professional | None | $138.04 | $213.80 | $346.74 |
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 $81.28 Median $85.11 Typical High $87.10 | Professional | 52 · Reduced service | $81.28 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $32.36 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $128.82 Typical High $131.83 | Professional | 54 · Surgery only | $120.23 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $25.70 Typical High $26.30 | Professional | 55 · Aftercare only | $23.99 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $16.22 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $120.23 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $112.20 | $120.23 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | 52 · Reduced service | $85.11 | $85.11 | $87.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $34.67 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 54 · Surgery only | $128.82 | $128.82 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $26.30 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $26.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $123.03 |
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· 10th of 51
$229
AK $501UT $97.72
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.