How much rates vary
Facilitymedian $1,622 · 10th to 90th $1,000 to $8,913Professionalmedian $1,349 · 10th to 90th $955 to $2,188
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 $5,128.61 Median $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,318.26 | Professional | None | $912.01 | $1,000.00 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,230.27 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,290.87 | Professional | None | $912.01 | $1,258.93 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,584.89 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $13,803.84 | Facility | None | $1,174.90 | $1,862.09 | $13,803.84 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,318.26 | $1,819.70 |
Pacific Source Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $1,737.80 | Facility | None | $954.99 | $1,584.89 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $1,174.90 Median $4,570.88 Typical High $7,762.47 | Facility | None | $1,174.90 | $4,570.88 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,380.38 Typical High $2,290.87 | Professional | None | $79.43 | $1,380.38 | $2,290.87 |
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 $1,288.25 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,659.59 | $1,995.26 |
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 $1,047.13 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,412.54 | $2,344.23 |
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 $457.09 Median $501.19 Typical High $660.69 | Professional | 52 · Reduced service | $457.09 | $501.19 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $263.03 | Professional | 53 · Discontinued | $181.97 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $977.24 | Professional | 54 · Surgery only | $676.08 | $758.58 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $194.98 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $100.00 Typical High $131.83 | Professional | 56 · Pre-op care only | $91.20 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $912.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $501.19 Typical High $660.69 | Professional | 52 · Reduced service | $467.74 | $501.19 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $263.03 | Professional | 53 · Discontinued | $186.21 | $199.53 | $263.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $758.58 Typical High $977.24 | Professional | 54 · Surgery only | $691.83 | $758.58 | $977.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $151.36 Typical High $194.98 | Professional | 55 · Aftercare only | $138.04 | $151.36 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $131.83 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $131.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $707.95 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $645.65 | $707.95 | $912.01 |
Where Oregon sits
The same service costs 4.4 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· 8th of 51
$1,380
AK $2,754NJ $631
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.