How much rates vary
Facilitymedian $447 · 10th to 90th $234 to $1,047Professionalmedian $355 · 10th to 90th $204 to $575
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 $147.91 Median $223.87 Typical High $380.19 | Professional | None | $147.91 | $223.87 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $660.69 | Facility | None | $323.59 | $407.38 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $588.84 | Professional | None | $204.17 | $363.08 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $660.69 | Professional | None | $257.04 | $371.54 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $549.54 Typical High $6,606.93 | Facility | None | $281.84 | $549.54 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $501.19 | Professional | None | $208.93 | $331.13 | $501.19 |
Pacific Source Setting Facility Modifier None Typical Low $269.15 Median $446.68 Typical High $489.78 | Facility | None | $269.15 | $446.68 | $489.78 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $416.87 Typical High $660.69 | Facility | None | $302.00 | $416.87 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $354.81 Typical High $602.56 | Professional | None | $79.43 | $354.81 | $602.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,621.81 | Facility | None | $954.99 | $1,348.96 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $489.78 | Professional | None | $263.03 | $446.68 | $489.78 |
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 $223.87 Median $371.54 Typical High $630.96 | Professional | None | $223.87 | $371.54 | $630.96 |
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 $104.71 Median $112.20 Typical High $190.55 | Professional | 52 · Reduced service | $104.71 | $112.20 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $75.86 | Professional | 53 · Discontinued | $41.69 | $44.67 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $165.96 Typical High $288.40 | Professional | 54 · Surgery only | $154.88 | $165.96 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $57.54 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $38.02 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $154.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $144.54 | $154.88 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $112.20 Typical High $190.55 | Professional | 52 · Reduced service | $104.71 | $112.20 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $75.86 | Professional | 53 · Discontinued | $41.69 | $44.67 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $165.96 Typical High $288.40 | Professional | 54 · Surgery only | $154.88 | $165.96 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.11 Typical High $57.54 | Professional | 55 · Aftercare only | $30.90 | $33.11 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $38.02 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $38.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $154.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $144.54 | $154.88 | $269.15 |
Where Oregon sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 5th of 51
$363
AK $562DC $162
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.