How much rates vary
Facilitymedian $851 · 10th to 90th $525 to $5,012Professionalmedian $813 · 10th to 90th $437 to $1,288
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 $501.19 Median $724.44 Typical High $724.44 | Professional | None | $501.19 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,754.23 Typical High $3,801.89 | Facility | None | $660.69 | $2,754.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,288.25 | Professional | None | $549.54 | $776.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,174.90 | Professional | None | $758.58 | $933.25 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $1,174.90 Typical High $7,943.28 | Facility | None | $741.31 | $1,174.90 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,148.15 | Professional | None | $645.65 | $724.44 | $1,148.15 |
Pacific Source Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $912.01 | Facility | None | $512.86 | $831.76 | $912.01 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,511.89 Typical High $3,801.89 | Facility | None | $660.69 | $2,511.89 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $831.76 Typical High $1,348.96 | Professional | None | $79.43 | $831.76 | $1,348.96 |
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 $870.96 Median $912.01 Typical High $1,230.27 | Professional | None | $870.96 | $912.01 | $1,230.27 |
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 $645.65 Median $812.83 Typical High $1,348.96 | Professional | None | $645.65 | $812.83 | $1,348.96 |
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 $245.47 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $245.47 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $100.00 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $371.54 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $74.13 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $50.12 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $346.74 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $338.84 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $134.90 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $501.19 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $72.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $501.19 |
Where Oregon sits
The same service costs 6.2 times more in Alaska 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· 10th of 51
$832
AK $1,862TX $302
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.