How much rates vary
Facilitymedian $589 · 10th to 90th $347 to $1,549Professionalmedian $525 · 10th to 90th $302 to $813
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 $295.12 Median $346.74 Typical High $562.34 | Professional | None | $295.12 | $346.74 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $851.14 | Professional | None | $302.00 | $489.78 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $758.58 | Professional | None | $380.19 | $524.81 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $812.83 Typical High $6,606.93 | Facility | None | $467.74 | $812.83 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $645.65 | Professional | None | $316.23 | $512.86 | $645.65 |
Pacific Source Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $676.08 | Facility | None | $398.11 | $588.84 | $676.08 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $870.96 | Facility | None | $446.68 | $602.56 | $870.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $501.19 Typical High $812.83 | Professional | None | $79.43 | $501.19 | $812.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,187.76 | Facility | None | $1,318.26 | $1,819.70 | $2,187.76 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $794.33 | Professional | None | $380.19 | $562.34 | $794.33 |
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 $363.08 Median $588.84 Typical High $954.99 | Professional | None | $363.08 | $588.84 | $954.99 |
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 $173.78 Median $173.78 Typical High $281.84 | Professional | 52 · Reduced service | $173.78 | $173.78 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $112.20 | Professional | 53 · Discontinued | $70.79 | $70.79 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $426.58 | Professional | 54 · Surgery only | $263.03 | $263.03 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $85.11 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $173.78 Typical High $281.84 | Professional | 52 · Reduced service | $173.78 | $173.78 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $112.20 | Professional | 53 · Discontinued | $70.79 | $70.79 | $112.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $426.58 | Professional | 54 · Surgery only | $263.03 | $263.03 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $85.11 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $56.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $398.11 |
Where Oregon sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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
$550
WI $933TX $251
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.