How much rates vary
Facilitymedian $339 · 10th to 90th $204 to $5,495Professionalmedian $275 · 10th to 90th $162 to $437
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $295.12 | Professional | None | $125.89 | $169.82 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $281.84 Typical High $891.25 | Facility | None | $223.87 | $281.84 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $467.74 | Professional | None | $162.18 | $281.84 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $467.74 | Professional | None | $190.55 | $281.84 | $467.74 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $416.87 Typical High $7,943.28 | Facility | None | $239.88 | $416.87 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $363.08 | Professional | None | $165.96 | $251.19 | $363.08 |
Pacific Source Setting Facility Modifier None Typical Low $194.98 Median $331.13 Typical High $380.19 | Facility | None | $194.98 | $331.13 | $380.19 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $288.40 Typical High $891.25 | Facility | None | $223.87 | $288.40 | $891.25 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $281.84 Typical High $478.63 | Professional | None | $79.43 | $281.84 | $478.63 |
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 $213.80 Median $346.74 Typical High $380.19 | Professional | None | $213.80 | $346.74 | $380.19 |
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 $177.83 Median $288.40 Typical High $489.78 | Professional | None | $177.83 | $288.40 | $489.78 |
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 $85.11 Median $85.11 Typical High $147.91 | Professional | 52 · Reduced service | $85.11 | $85.11 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $34.67 Typical High $58.88 | Professional | 53 · Discontinued | $33.88 | $34.67 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $128.82 Typical High $223.87 | Professional | 54 · Surgery only | $125.89 | $128.82 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.70 Typical High $44.67 | Professional | 55 · Aftercare only | $25.12 | $25.70 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.98 | $17.38 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $120.23 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $117.49 | $120.23 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $85.11 Typical High $147.91 | Professional | 52 · Reduced service | $85.11 | $85.11 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $34.67 Typical High $58.88 | Professional | 53 · Discontinued | $33.88 | $34.67 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $128.82 Typical High $223.87 | Professional | 54 · Surgery only | $125.89 | $128.82 | $223.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.70 Typical High $44.67 | Professional | 55 · Aftercare only | $25.12 | $25.70 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.98 | $17.38 | $29.51 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $120.23 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $117.49 | $120.23 | $208.93 |
Where Oregon sits
The same service costs 3.4 times more in Alaska than in Florida. 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
$282
AK $447FL $132
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.