How much rates vary
Facilitymedian $437 · 10th to 90th $204 to $708Professionalmedian $339 · 10th to 90th $178 to $708
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 $134.90 Median $218.78 Typical High $416.87 | Professional | None | $134.90 | $218.78 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $354.81 | Facility | None | $141.25 | $251.19 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $346.74 Typical High $758.58 | Professional | None | $181.97 | $346.74 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $645.65 | Professional | None | $213.80 | $323.59 | $645.65 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $549.54 Typical High $6,606.93 | Facility | None | $251.19 | $549.54 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $478.63 | Professional | None | $177.83 | $288.40 | $478.63 |
Pacific Source Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $537.03 | Facility | None | $275.42 | $446.68 | $537.03 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $269.15 Typical High $630.96 | Facility | None | $181.97 | $269.15 | $630.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $323.59 Typical High $724.44 | Professional | None | $79.43 | $323.59 | $724.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $912.01 | Facility | None | $602.56 | $812.83 | $912.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $724.44 | Professional | None | $234.42 | $398.11 | $724.44 |
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 $194.98 Median $389.05 Typical High $758.58 | Professional | None | $194.98 | $389.05 | $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 $89.13 Median $89.13 Typical High $208.93 | Professional | 52 · Reduced service | $89.13 | $89.13 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $83.18 | Professional | 53 · Discontinued | $36.31 | $36.31 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $316.23 | Professional | 54 · Surgery only | $134.90 | $134.90 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $63.10 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $41.69 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $89.13 Typical High $208.93 | Professional | 52 · Reduced service | $89.13 | $89.13 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $83.18 | Professional | 53 · Discontinued | $36.31 | $36.31 | $83.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $316.23 | Professional | 54 · Surgery only | $134.90 | $134.90 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $63.10 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $41.69 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $41.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $295.12 |
Where Oregon sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 4th of 51
$380
WI $490KY $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.