How much rates vary
Facilitymedian $219 · 10th to 90th $138 to $794Professionalmedian $200 · 10th to 90th $132 to $309
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 $100.00 Median $144.54 Typical High $165.96 | Professional | None | $100.00 | $144.54 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $165.96 Typical High $229.09 | Facility | None | $95.50 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $323.59 | Professional | None | $131.83 | $194.98 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $316.23 | Professional | None | $208.93 | $257.04 | $316.23 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $6,606.93 | Facility | None | $165.96 | $275.42 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $257.04 | Professional | None | $144.54 | $169.82 | $257.04 |
Pacific Source Setting Facility Modifier None Typical Low $134.90 Median $218.78 Typical High $239.88 | Facility | None | $134.90 | $218.78 | $239.88 |
Providence Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $281.84 | Facility | None | $138.04 | $186.21 | $281.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $316.23 | Professional | None | $79.43 | $199.53 | $316.23 |
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 $199.53 Median $229.09 Typical High $288.40 | Professional | None | $199.53 | $229.09 | $288.40 |
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 $131.83 Median $199.53 Typical High $338.84 | Professional | None | $131.83 | $199.53 | $338.84 |
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 $64.57 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $64.57 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.84 Typical High $33.11 | Professional | 53 · Discontinued | $26.30 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $123.03 | Professional | 54 · Surgery only | $97.72 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.38 Typical High $24.55 | Professional | 55 · Aftercare only | $19.50 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.45 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.18 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $100.00 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $91.20 | $100.00 | $114.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $70.79 | $70.79 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $33.11 | Professional | 53 · Discontinued | $28.84 | $28.84 | $33.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 54 · Surgery only | $107.15 | $107.15 | $123.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $24.55 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $16.60 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $16.60 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $100.00 | $100.00 | $114.82 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Facility | 50 · Both sides | $954.99 | $1,230.27 | $1,445.44 |
Where Oregon sits
The same service costs 4.5 times more in Alaska than in Florida. 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
$204
AK $427FL $95.50
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.