How much rates vary
Facilitymedian $380 · 10th to 90th $224 to $2,188Professionalmedian $302 · 10th to 90th $178 to $513
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 $645.65 Median $5,128.61 Typical High $7,943.28 | Facility | None | $645.65 | $5,128.61 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $309.03 | Professional | None | $177.83 | $181.97 | $309.03 |
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 $177.83 Median $295.12 Typical High $537.03 | Professional | None | $177.83 | $295.12 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $512.86 | Professional | None | $229.09 | $338.84 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $446.68 Typical High $7,943.28 | Facility | None | $251.19 | $446.68 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $398.11 | Professional | None | $177.83 | $309.03 | $398.11 |
Pacific Source Setting Facility Modifier None Typical Low $223.87 Median $354.81 Typical High $389.05 | Facility | None | $223.87 | $354.81 | $389.05 |
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 $295.12 Typical High $512.86 | Professional | None | $79.43 | $295.12 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $3,630.78 | Facility | None | $2,344.23 | $3,162.28 | $3,630.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $512.86 | Professional | None | $218.78 | $363.08 | $512.86 |
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 $194.98 Median $331.13 Typical High $549.54 | Professional | None | $194.98 | $331.13 | $549.54 |
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 $154.88 | Professional | 52 · Reduced service | $89.13 | $89.13 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $61.66 | Professional | 53 · Discontinued | $35.48 | $35.48 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $234.42 | Professional | 54 · Surgery only | $131.83 | $131.83 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $46.77 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $30.90 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $89.13 Typical High $154.88 | Professional | 52 · Reduced service | $89.13 | $89.13 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $61.66 | Professional | 53 · Discontinued | $35.48 | $35.48 | $61.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $234.42 | Professional | 54 · Surgery only | $131.83 | $131.83 | $234.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $46.77 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $30.90 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $30.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $218.78 |
Where Oregon sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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
$324
WI $589HI $155
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.