How much rates vary
Facilitymedian $891 · 10th to 90th $537 to $7,762Professionalmedian $724 · 10th to 90th $479 to $1,096
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 $416.87 Median $512.86 Typical High $741.31 | Professional | None | $416.87 | $512.86 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,623.41 Typical High $7,762.47 | Facility | None | $891.25 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $1,122.02 | Professional | None | $478.63 | $676.08 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,148.15 | Professional | None | $575.44 | $831.76 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $7,943.28 | Facility | None | $741.31 | $1,047.13 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $977.24 | Professional | None | $501.19 | $691.83 | $977.24 |
Pacific Source Setting Facility Modifier None Typical Low $537.03 Median $851.14 Typical High $891.25 | Facility | None | $537.03 | $851.14 | $891.25 |
Providence Setting Facility Modifier None Typical Low $724.44 Median $4,570.88 Typical High $7,762.47 | Facility | None | $724.44 | $4,570.88 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $707.95 Typical High $1,148.15 | Professional | None | $79.43 | $707.95 | $1,148.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $20,417.38 Typical High $23,442.29 | Facility | None | $14,454.40 | $20,417.38 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,047.13 | Professional | None | $616.60 | $851.14 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,202.26 | Professional | None | $537.03 | $776.25 | $1,202.26 |
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 $234.42 Median $257.04 Typical High $371.54 | Professional | 52 · Reduced service | $234.42 | $257.04 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $102.33 Typical High $147.91 | Professional | 53 · Discontinued | $93.33 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $549.54 | Professional | 54 · Surgery only | $354.81 | $389.05 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $109.65 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $51.29 Typical High $74.13 | Professional | 56 · Pre-op care only | $46.77 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $257.04 Typical High $371.54 | Professional | 52 · Reduced service | $251.19 | $257.04 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | 53 · Discontinued | $102.33 | $102.33 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $549.54 | Professional | 54 · Surgery only | $371.54 | $389.05 | $549.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $109.65 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $74.13 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $74.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $512.86 |
Where Oregon sits
The same service costs 4.0 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· 7th of 51
$741
AK $1,318NJ $331
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.