How much rates vary
Facilitymedian $309 · 10th to 90th $186 to $708Professionalmedian $282 · 10th to 90th $174 to $437
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 $251.19 Median $4,677.35 Typical High $7,943.28 | Facility | None | $251.19 | $4,677.35 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $251.19 | Professional | None | $144.54 | $204.17 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $229.09 Typical High $323.59 | Facility | None | $128.82 | $229.09 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $457.09 | Professional | None | $181.97 | $269.15 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $446.68 | Professional | None | $295.12 | $363.08 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $346.74 Typical High $6,606.93 | Facility | None | $239.88 | $346.74 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $354.81 | Professional | None | $162.18 | $234.42 | $354.81 |
Pacific Source Setting Facility Modifier None Typical Low $186.21 Median $309.03 Typical High $338.84 | Facility | None | $186.21 | $309.03 | $338.84 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $251.19 Typical High $398.11 | Facility | None | $190.55 | $251.19 | $398.11 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $281.84 Typical High $446.68 | Professional | None | $79.43 | $281.84 | $446.68 |
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 $281.84 Median $323.59 Typical High $407.38 | Professional | None | $281.84 | $323.59 | $407.38 |
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 $186.21 Median $281.84 Typical High $478.63 | Professional | None | $186.21 | $281.84 | $478.63 |
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 $93.33 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $93.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $38.02 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $141.25 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $28.18 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.62 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $131.83 | $141.25 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $102.33 | $102.33 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $40.74 | $40.74 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $151.36 | $151.36 | $177.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $23.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $141.25 | $141.25 | $165.96 |
Where Oregon sits
The same service costs 4.9 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
$282
AK $603UT $123
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.