How much rates vary
Facilitymedian $417 · 10th to 90th $251 to $3,981Professionalmedian $339 · 10th to 90th $229 to $525
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 $204.17 Median $234.42 Typical High $338.84 | Professional | None | $204.17 | $234.42 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $1,698.24 | Facility | None | $660.69 | $1,258.93 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $537.03 | Professional | None | $234.42 | $323.59 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $524.81 | Professional | None | $269.15 | $389.05 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $489.78 Typical High $6,606.93 | Facility | None | $323.59 | $489.78 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $457.09 | Professional | None | $234.42 | $331.13 | $457.09 |
Pacific Source Setting Facility Modifier None Typical Low $245.47 Median $398.11 Typical High $436.52 | Facility | None | $245.47 | $398.11 | $436.52 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $1,000.00 Typical High $1,698.24 | Facility | None | $354.81 | $1,000.00 | $1,698.24 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $338.84 Typical High $549.54 | Professional | None | $79.43 | $338.84 | $549.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $6,025.60 | Facility | None | $3,801.89 | $5,248.07 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $489.78 | Professional | None | $302.00 | $416.87 | $489.78 |
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 $245.47 Median $363.08 Typical High $562.34 | Professional | None | $245.47 | $363.08 | $562.34 |
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 $107.15 Median $117.49 Typical High $169.82 | Professional | 52 · Reduced service | $107.15 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $46.77 Typical High $67.61 | Professional | 53 · Discontinued | $43.65 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $177.83 Typical High $257.04 | Professional | 54 · Surgery only | $162.18 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $32.36 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.44 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.88 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $165.96 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $151.36 | $165.96 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $117.49 Typical High $169.82 | Professional | 52 · Reduced service | $117.49 | $117.49 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $67.61 | Professional | 53 · Discontinued | $46.77 | $46.77 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $177.83 Typical High $257.04 | Professional | 54 · Surgery only | $173.78 | $177.83 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $33.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $165.96 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $162.18 | $165.96 | $239.88 |
Where Oregon sits
The same service costs 4.2 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
$339
AK $646NJ $155
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.