How much rates vary
Facilitymedian $282 · 10th to 90th $170 to $1,288Professionalmedian $245 · 10th to 90th $151 to $407
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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $234.42 | Professional | None | $151.36 | $151.36 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $234.42 Typical High $660.69 | Facility | None | $186.21 | $234.42 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $426.58 | Professional | None | $154.88 | $251.19 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $380.19 | Professional | None | $190.55 | $263.03 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $281.84 Typical High $7,943.28 | Facility | None | $204.17 | $281.84 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $331.13 | Professional | None | $151.36 | $234.42 | $331.13 |
Pacific Source Setting Facility Modifier None Typical Low $169.82 Median $281.84 Typical High $309.03 | Facility | None | $169.82 | $281.84 | $309.03 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $245.47 Typical High $707.95 | Facility | None | $186.21 | $245.47 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $251.19 Typical High $407.38 | Professional | None | $79.43 | $251.19 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $6,025.60 | Facility | None | $3,801.89 | $5,248.07 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $407.38 | Professional | None | $199.53 | $288.40 | $407.38 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $436.52 | Professional | None | $162.18 | $269.15 | $436.52 |
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 $75.86 Median $75.86 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $46.77 | Professional | 53 · Discontinued | $30.90 | $30.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $177.83 | Professional | 54 · Surgery only | $114.82 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $75.86 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $75.86 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $46.77 | Professional | 53 · Discontinued | $30.90 | $30.90 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $177.83 | Professional | 54 · Surgery only | $114.82 | $114.82 | $177.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $23.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $165.96 |
Where Oregon sits
The same service costs 4.4 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· 6th of 51
$263
AK $417KY $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.