How much rates vary
Facilitymedian $363 · 10th to 90th $204 to $490Professionalmedian $316 · 10th to 90th $141 to $550
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 $190.55 Median $5,128.61 Typical High $7,943.28 | Facility | None | $190.55 | $5,128.61 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $363.08 | Professional | None | $123.03 | $223.87 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $602.56 | Professional | None | $181.97 | $316.23 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $524.81 | Professional | None | $229.09 | $338.84 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $436.52 Typical High $1,000.00 | Facility | None | $257.04 | $436.52 | $1,000.00 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $288.40 Typical High $478.63 | Professional | None | $141.25 | $288.40 | $478.63 |
Pacific Source Setting Facility Modifier None Typical Low $218.78 Median $363.08 Typical High $426.58 | Facility | None | $218.78 | $363.08 | $426.58 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $758.58 | Facility | None | $100.00 | $363.08 | $758.58 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $316.23 Typical High $575.44 | Professional | None | $79.43 | $316.23 | $575.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $446.68 Typical High $512.86 | Facility | None | $323.59 | $446.68 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $575.44 | Professional | None | $234.42 | $398.11 | $575.44 |
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 $186.21 Median $331.13 Typical High $588.84 | Professional | None | $186.21 | $331.13 | $588.84 |
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 $93.33 Median $93.33 Typical High $162.18 | Professional | 52 · Reduced service | $93.33 | $93.33 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $64.57 | Professional | 53 · Discontinued | $37.15 | $37.15 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $239.88 | Professional | 54 · Surgery only | $138.04 | $138.04 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $47.86 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $93.33 Typical High $162.18 | Professional | 52 · Reduced service | $93.33 | $93.33 | $162.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $64.57 | Professional | 53 · Discontinued | $37.15 | $37.15 | $64.57 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $239.88 | Professional | 54 · Surgery only | $138.04 | $138.04 | $239.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $47.86 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $32.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $223.87 |
Where Oregon sits
The same service costs 4.5 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
$331
AK $501KY $112
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.