How much rates vary
Facilitymedian $501 · 10th to 90th $295 to $4,898Professionalmedian $417 · 10th to 90th $245 to $692
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 $199.53 Median $275.42 Typical High $426.58 | Professional | None | $199.53 | $275.42 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $416.87 Typical High $660.69 | Facility | None | $331.13 | $416.87 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $741.31 | Professional | None | $251.19 | $416.87 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $630.96 | Professional | None | $302.00 | $436.52 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $616.60 Typical High $6,606.93 | Facility | None | $371.54 | $616.60 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $524.81 | Professional | None | $251.19 | $338.84 | $524.81 |
Pacific Source Setting Facility Modifier None Typical Low $295.12 Median $467.74 Typical High $524.81 | Facility | None | $295.12 | $467.74 | $524.81 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $741.31 | Facility | None | $331.13 | $436.52 | $741.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $416.87 Typical High $707.95 | Professional | None | $79.43 | $416.87 | $707.95 |
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 $316.23 Median $501.19 Typical High $707.95 | Professional | None | $316.23 | $501.19 | $707.95 |
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 $275.42 Median $446.68 Typical High $724.44 | Professional | None | $275.42 | $446.68 | $724.44 |
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 $134.90 Median $134.90 Typical High $213.80 | Professional | 52 · Reduced service | $134.90 | $134.90 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $85.11 | Professional | 53 · Discontinued | $53.70 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $199.53 | $199.53 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $64.57 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $42.66 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $134.90 Typical High $213.80 | Professional | 52 · Reduced service | $134.90 | $134.90 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $85.11 | Professional | 53 · Discontinued | $53.70 | $53.70 | $85.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $199.53 | $199.53 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $64.57 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $42.66 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $42.66 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $302.00 |
Where Oregon sits
The same service costs 4.3 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· 7th of 51
$437
WI $794KY $186
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.