How much rates vary
Facilitymedian $447 · 10th to 90th $214 to $1,549Professionalmedian $339 · 10th to 90th $182 to $724
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 $131.83 Median $218.78 Typical High $426.58 | Professional | None | $131.83 | $218.78 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $416.87 Typical High $575.44 | Facility | None | $234.42 | $416.87 | $575.44 |
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 $218.78 Median $323.59 Typical High $660.69 | Professional | None | $218.78 | $323.59 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $562.34 Typical High $6,606.93 | Facility | None | $251.19 | $562.34 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $489.78 | Professional | None | $181.97 | $309.03 | $489.78 |
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 $234.42 Median $426.58 Typical High $660.69 | Facility | None | $234.42 | $426.58 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $331.13 Typical High $741.31 | Professional | None | $79.43 | $331.13 | $741.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,041.74 | Facility | None | $1,318.26 | $1,778.28 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $741.31 | Professional | None | $234.42 | $398.11 | $741.31 |
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 $91.20 Median $91.20 Typical High $208.93 | Professional | 52 · Reduced service | $91.20 | $91.20 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $85.11 | Professional | 53 · Discontinued | $36.31 | $36.31 | $85.11 |
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 $18.20 Median $18.20 Typical High $42.66 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $42.66 |
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 $91.20 Median $91.20 Typical High $208.93 | Professional | 52 · Reduced service | $91.20 | $91.20 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $85.11 | Professional | 53 · Discontinued | $36.31 | $36.31 | $85.11 |
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 $18.20 Median $18.20 Typical High $42.66 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $42.66 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $125.89 | $239.88 | $295.12 |
Where Oregon sits
The same service costs 3.9 times more in Alaska 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
$398
AK $562KY $145
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.