How much rates vary
Facilitymedian $631 · 10th to 90th $398 to $3,715Professionalmedian $525 · 10th to 90th $324 to $832
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 $338.84 Median $338.84 Typical High $562.34 | Professional | None | $338.84 | $338.84 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $524.81 Typical High $870.96 | Facility | None | $426.58 | $524.81 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $870.96 | Professional | None | $323.59 | $524.81 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $912.01 | Professional | None | $380.19 | $562.34 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $7,943.28 | Facility | None | $467.74 | $758.58 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $724.44 | Professional | None | $338.84 | $501.19 | $724.44 |
Pacific Source Setting Facility Modifier None Typical Low $398.11 Median $602.56 Typical High $707.95 | Facility | None | $398.11 | $602.56 | $707.95 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $933.25 | Facility | None | $416.87 | $537.03 | $933.25 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $891.25 | Professional | None | $79.43 | $524.81 | $891.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,981.07 Median $5,754.40 Typical High $7,413.10 | Facility | None | $3,981.07 | $5,754.40 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $724.44 | Professional | None | $426.58 | $660.69 | $724.44 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $933.25 | Professional | None | $363.08 | $562.34 | $933.25 |
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 $169.82 Median $169.82 Typical High $275.42 | Professional | 52 · Reduced service | $169.82 | $169.82 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $112.20 | Professional | 53 · Discontinued | $67.61 | $67.61 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $416.87 | Professional | 54 · Surgery only | $251.19 | $251.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $83.18 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $169.82 Typical High $275.42 | Professional | 52 · Reduced service | $169.82 | $169.82 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $112.20 | Professional | 53 · Discontinued | $67.61 | $67.61 | $112.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $416.87 | Professional | 54 · Surgery only | $251.19 | $251.19 | $416.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $83.18 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $56.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $389.05 |
Where Oregon sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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
$537
AK $912NJ $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.