How much rates vary
Facilitymedian $355 · 10th to 90th $200 to $37,154Professionalmedian $813 · 10th to 90th $79 to $1,413
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 $616.60 Median $676.08 Typical High $676.08 | Professional | None | $616.60 | $676.08 | $676.08 |
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 $707.95 Median $794.33 Typical High $1,348.96 | Professional | None | $707.95 | $794.33 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,174.90 | Professional | None | $776.25 | $954.99 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $7,943.28 | Facility | None | $676.08 | $954.99 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | None | $616.60 | $676.08 | $676.08 |
Pacific Source Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $891.25 | Facility | None | $199.53 | $331.13 | $891.25 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $251,188.64 Typical High $251,188.64 | Facility | None | $758.58 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $707.95 Typical High $1,445.44 | Professional | None | $79.43 | $707.95 | $1,445.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,230.27 | Professional | None | $912.01 | $977.24 | $1,230.27 |
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 $691.83 Median $851.14 Typical High $1,479.11 | Professional | None | $691.83 | $851.14 | $1,479.11 |
8 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 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $457.09 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $457.09 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $467.74 |
Where Oregon sits
The same service costs 11.7 times more in New York than in North Carolina. 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
$794
NY $3,802NC $324
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.