How much rates vary
Facilitymedian $692 · 10th to 90th $240 to $933Professionalmedian $741 · 10th to 90th $398 to $1,148
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 $467.74 Median $630.96 Typical High $630.96 | Professional | None | $467.74 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $354.81 | Facility | None | $141.25 | $251.19 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,148.15 | Professional | None | $489.78 | $691.83 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,000.00 | Professional | None | $616.60 | $776.25 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $1,148.15 Typical High $7,943.28 | Facility | None | $630.96 | $1,148.15 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $1,000.00 | Professional | None | $588.84 | $630.96 | $1,000.00 |
Pacific Source Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $831.76 | Facility | None | $467.74 | $776.25 | $831.76 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $269.15 Typical High $977.24 | Facility | None | $194.98 | $269.15 | $977.24 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $758.58 Typical High $1,230.27 | Professional | None | $79.43 | $758.58 | $1,230.27 |
Regence BlueShield Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $912.01 | Facility | None | $602.56 | $812.83 | $912.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,096.48 | Professional | None | $776.25 | $831.76 | $1,096.48 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,230.27 | Professional | None | $602.56 | $741.31 | $1,230.27 |
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 $229.09 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $229.09 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $91.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $338.84 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $69.18 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $316.23 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $288.40 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $114.82 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $426.58 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $57.54 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $436.52 |
Where Oregon sits
The same service costs 4.2 times more in Wyoming 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· 9th of 51
$741
WY $1,288UT $309
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.