How much rates vary
Facilitymedian $398 · 10th to 90th $240 to $4,786Professionalmedian $324 · 10th to 90th $170 to $575
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 $125.89 Median $199.53 Typical High $346.74 | Professional | None | $125.89 | $199.53 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $338.84 Typical High $870.96 | Facility | None | $269.15 | $338.84 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $616.60 | Professional | None | $181.97 | $323.59 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $537.03 | Professional | None | $223.87 | $338.84 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $512.86 Typical High $6,606.93 | Facility | None | $269.15 | $512.86 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $426.58 | Professional | None | $144.54 | $239.88 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $239.88 Median $398.11 Typical High $436.52 | Facility | None | $239.88 | $398.11 | $436.52 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $346.74 Typical High $831.76 | Facility | None | $251.19 | $346.74 | $831.76 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $323.59 Typical High $588.84 | Professional | None | $79.43 | $323.59 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $10,964.78 Typical High $12,882.50 | Facility | None | $7,413.10 | $10,964.78 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $588.84 | Professional | None | $234.42 | $398.11 | $588.84 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $616.60 | Professional | None | $204.17 | $346.74 | $616.60 |
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 $95.50 Median $95.50 Typical High $173.78 | Professional | 52 · Reduced service | $95.50 | $95.50 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $69.18 | Professional | 53 · Discontinued | $38.02 | $38.02 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $263.03 | Professional | 54 · Surgery only | $141.25 | $141.25 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $52.48 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $173.78 | Professional | 52 · Reduced service | $95.50 | $95.50 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $69.18 | Professional | 53 · Discontinued | $38.02 | $38.02 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $263.03 | Professional | 54 · Surgery only | $141.25 | $141.25 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $52.48 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $34.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $245.47 |
Where Oregon sits
The same service costs 3.8 times more in Wisconsin 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
$347
WI $631KY $166
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.