How much rates vary
Facilitymedian $912 · 10th to 90th $501 to $37,154Professionalmedian $3,548 · 10th to 90th $79 to $5,754
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,454.71 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $23,988.33 | Facility | None | $549.54 | $1,000.00 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $5,754.40 | Professional | None | $2,884.03 | $3,388.44 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,162.28 Median $3,890.45 Typical High $5,011.87 | Professional | None | $3,162.28 | $3,890.45 | $5,011.87 |
Moda Health Setting Facility Modifier None Typical Low $2,951.21 Median $7,943.28 Typical High $29,512.09 | Facility | None | $2,951.21 | $7,943.28 | $29,512.09 |
Moda Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,754.23 | $2,951.21 | $2,951.21 |
Pacific Source Setting Facility Modifier None Typical Low $501.19 Median $831.76 Typical High $3,090.30 | Facility | None | $501.19 | $831.76 | $3,090.30 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,000.00 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,019.95 Typical High $6,165.95 | Professional | None | $79.43 | $3,019.95 | $6,165.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,981.07 Median $4,265.80 Typical High $5,495.41 | Professional | None | $3,981.07 | $4,265.80 | $5,495.41 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $6,606.93 | Professional | None | $3,090.30 | $3,801.89 | $6,606.93 |
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 $1,348.96 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,348.96 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $549.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,041.74 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $407.38 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $275.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,348.96 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,348.96 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $549.54 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,041.74 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $407.38 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $275.42 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,089.30 | $2,089.30 |
Where Oregon sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 13th of 51
$3,388
AK $8,511KY $871
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.