How much rates vary
Facilitymedian $603 · 10th to 90th $363 to $4,467Professionalmedian $468 · 10th to 90th $324 to $759
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 $263.03 Median $338.84 Typical High $467.74 | Professional | None | $263.03 | $338.84 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,258.93 Typical High $1,698.24 | Facility | None | $724.44 | $1,258.93 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $776.25 | Professional | None | $331.13 | $457.09 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $741.31 | Professional | None | $380.19 | $549.54 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $676.08 Typical High $7,943.28 | Facility | None | $467.74 | $676.08 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $707.95 | Professional | None | $323.59 | $467.74 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $346.74 Median $562.34 Typical High $616.60 | Facility | None | $346.74 | $562.34 | $616.60 |
Providence Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $1,698.24 | Facility | None | $524.81 | $1,071.52 | $1,698.24 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $478.63 Typical High $776.25 | Professional | None | $79.43 | $478.63 | $776.25 |
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 $436.52 Median $588.84 Typical High $691.83 | Professional | None | $436.52 | $588.84 | $691.83 |
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 $512.86 Typical High $794.33 | Professional | None | $363.08 | $512.86 | $794.33 |
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 $154.88 Median $169.82 Typical High $234.42 | Professional | 52 · Reduced service | $154.88 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $69.18 Typical High $93.33 | Professional | 53 · Discontinued | $63.10 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $257.04 Typical High $354.81 | Professional | 54 · Surgery only | $234.42 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $51.29 Typical High $70.79 | Professional | 55 · Aftercare only | $46.77 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $46.77 | Professional | 56 · Pre-op care only | $30.90 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $239.88 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $218.78 | $239.88 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $169.82 Typical High $234.42 | Professional | 52 · Reduced service | $165.96 | $169.82 | $234.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $69.18 Typical High $93.33 | Professional | 53 · Discontinued | $66.07 | $69.18 | $93.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $257.04 Typical High $354.81 | Professional | 54 · Surgery only | $245.47 | $257.04 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $70.79 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $70.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $46.77 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $46.77 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $239.88 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $229.09 | $239.88 | $331.13 |
Where Oregon sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$479
AK $933UT $219
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.