How much rates vary
Facilitymedian $295 · 10th to 90th $178 to $813Professionalmedian $257 · 10th to 90th $166 to $380
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 $144.54 Median $177.83 Typical High $213.80 | Professional | None | $144.54 | $177.83 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $316.23 Typical High $660.69 | Facility | None | $251.19 | $316.23 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $398.11 | Professional | None | $162.18 | $229.09 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $389.05 | Professional | None | $239.88 | $302.00 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $363.08 Typical High $6,606.93 | Facility | None | $213.80 | $363.08 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $323.59 | Professional | None | $177.83 | $213.80 | $323.59 |
Pacific Source Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $309.03 | Facility | None | $177.83 | $288.40 | $309.03 |
Providence Setting Facility Modifier None Typical Low $234.42 Median $316.23 Typical High $660.69 | Facility | None | $234.42 | $316.23 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $257.04 Typical High $398.11 | Professional | None | $79.43 | $257.04 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,047.13 | Facility | None | $691.83 | $933.25 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $354.81 | Professional | None | $245.47 | $295.12 | $354.81 |
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 $173.78 Median $263.03 Typical High $416.87 | Professional | None | $173.78 | $263.03 | $416.87 |
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 $79.43 Median $89.13 Typical High $107.15 | Professional | 52 · Reduced service | $79.43 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $32.36 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $120.23 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $23.99 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.78 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.22 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $112.20 | $125.89 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | 52 · Reduced service | $89.13 | $89.13 | $107.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $35.48 | $35.48 | $42.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $134.90 | $134.90 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $21.38 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $21.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $151.36 |
Where Oregon sits
The same service costs 3.8 times more in Alaska than in Delaware. 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
$257
AK $513DE $135
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.