How much rates vary
Facilitymedian $525 · 10th to 90th $316 to $2,399Professionalmedian $427 · 10th to 90th $269 to $692
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 $1,000.00 Median $5,011.87 Typical High $7,943.28 | Facility | None | $1,000.00 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $457.09 | Professional | None | $204.17 | $302.00 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $489.78 Typical High $676.08 | Facility | None | $389.05 | $489.78 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $707.95 | Professional | None | $288.40 | $426.58 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $794.33 | Professional | None | $371.54 | $549.54 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $645.65 Typical High $6,606.93 | Facility | None | $331.13 | $645.65 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $691.83 | Professional | None | $269.15 | $398.11 | $691.83 |
Pacific Source Setting Facility Modifier None Typical Low $309.03 Median $512.86 Typical High $575.44 | Facility | None | $309.03 | $512.86 | $575.44 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $501.19 Typical High $758.58 | Facility | None | $380.19 | $501.19 | $758.58 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $426.58 Typical High $707.95 | Professional | None | $79.43 | $426.58 | $707.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $3,630.78 | Facility | None | $2,290.87 | $3,162.28 | $3,630.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $616.60 | Professional | None | $371.54 | $524.81 | $616.60 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $741.31 | Professional | None | $302.00 | $457.09 | $741.31 |
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 $138.04 Median $151.36 Typical High $229.09 | Professional | 52 · Reduced service | $138.04 | $151.36 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $91.20 | Professional | 53 · Discontinued | $56.23 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $346.74 | Professional | 54 · Surgery only | $208.93 | $223.87 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $69.18 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $45.71 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $208.93 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $194.98 | $208.93 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $151.36 Typical High $229.09 | Professional | 52 · Reduced service | $151.36 | $151.36 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $91.20 | Professional | 53 · Discontinued | $60.26 | $60.26 | $91.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $346.74 | Professional | 54 · Surgery only | $223.87 | $223.87 | $346.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $69.18 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $45.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $323.59 |
Where Oregon sits
The same service costs 3.8 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· 7th of 51
$447
AK $776KY $204
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.