How much rates vary
Facilitymedian $447 · 10th to 90th $269 to $4,898Professionalmedian $355 · 10th to 90th $240 to $562
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 $371.54 Median $5,011.87 Typical High $7,943.28 | Facility | None | $371.54 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $363.08 | Professional | None | $186.21 | $251.19 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $316.23 Typical High $870.96 | Facility | None | $251.19 | $316.23 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $575.44 | Professional | None | $245.47 | $346.74 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $575.44 | Professional | None | $288.40 | $407.38 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $524.81 Typical High $6,606.93 | Facility | None | $275.42 | $524.81 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $489.78 | Professional | None | $239.88 | $346.74 | $489.78 |
Pacific Source Setting Facility Modifier None Typical Low $269.15 Median $446.68 Typical High $478.63 | Facility | None | $269.15 | $446.68 | $478.63 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $354.81 Typical High $831.76 | Facility | None | $251.19 | $354.81 | $831.76 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $363.08 Typical High $588.84 | Professional | None | $79.43 | $363.08 | $588.84 |
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 $316.23 Median $436.52 Typical High $512.86 | Professional | None | $316.23 | $436.52 | $512.86 |
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 $269.15 Median $389.05 Typical High $616.60 | Professional | None | $269.15 | $389.05 | $616.60 |
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 $114.82 Median $125.89 Typical High $181.97 | Professional | 52 · Reduced service | $114.82 | $125.89 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $50.12 Typical High $72.44 | Professional | 53 · Discontinued | $45.71 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $186.21 Typical High $275.42 | Professional | 54 · Surgery only | $173.78 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $54.95 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.12 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $25.12 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $173.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $162.18 | $173.78 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | 52 · Reduced service | $125.89 | $125.89 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $72.44 | Professional | 53 · Discontinued | $50.12 | $50.12 | $72.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $275.42 | Professional | 54 · Surgery only | $186.21 | $186.21 | $275.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $54.95 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $36.31 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $257.04 |
Where Oregon sits
The same service costs 3.8 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
$363
AK $646NJ $170
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.