How much rates vary
Facilitymedian $339 · 10th to 90th $186 to $676Professionalmedian $282 · 10th to 90th $132 to $501
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 $102.33 Median $173.78 Typical High $288.40 | Professional | None | $102.33 | $173.78 | $288.40 |
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 $165.96 Median $281.84 Typical High $537.03 | Professional | None | $165.96 | $281.84 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $467.74 | Professional | None | $199.53 | $295.12 | $467.74 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $407.38 Typical High $6,606.93 | Facility | None | $223.87 | $407.38 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $354.81 | Professional | None | $117.49 | $208.93 | $354.81 |
Pacific Source Setting Facility Modifier None Typical Low $208.93 Median $338.84 Typical High $371.54 | Facility | None | $208.93 | $338.84 | $371.54 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $263.03 Typical High $457.09 | Facility | None | $169.82 | $263.03 | $457.09 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $281.84 Typical High $512.86 | Professional | None | $79.43 | $281.84 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $977.24 | Facility | None | $602.56 | $812.83 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $501.19 | Professional | None | $213.80 | $354.81 | $501.19 |
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 $302.00 Typical High $524.81 | Professional | None | $173.78 | $302.00 | $524.81 |
13 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 $81.28 Median $81.28 Typical High $144.54 | Professional | 52 · Reduced service | $81.28 | $81.28 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $57.54 | Professional | 53 · Discontinued | $32.36 | $32.36 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $213.80 | Professional | 54 · Surgery only | $120.23 | $120.23 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $43.65 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $81.28 Typical High $144.54 | Professional | 52 · Reduced service | $81.28 | $81.28 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $57.54 | Professional | 53 · Discontinued | $32.36 | $32.36 | $57.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $213.80 | Professional | 54 · Surgery only | $120.23 | $120.23 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $43.65 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $28.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $199.53 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $912.01 Median $1,230.27 Typical High $1,445.44 | Facility | 50 · Both sides | $912.01 | $1,230.27 | $1,445.44 |
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
$295
AK $457KY $102
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.