How much rates vary
Facilitymedian $355 · 10th to 90th $204 to $4,571Professionalmedian $339 · 10th to 90th $214 to $525
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 $194.98 Median $213.80 Typical High $251.19 | Professional | None | $194.98 | $213.80 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $181.97 Typical High $870.96 | Facility | None | $144.54 | $181.97 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $524.81 | Professional | None | $239.88 | $323.59 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $457.09 | Professional | None | $281.84 | $363.08 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $446.68 Typical High $6,606.93 | Facility | None | $251.19 | $446.68 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $489.78 | Professional | None | $213.80 | $269.15 | $489.78 |
Pacific Source Setting Facility Modifier None Typical Low $223.87 Median $354.81 Typical High $380.19 | Facility | None | $223.87 | $354.81 | $380.19 |
Providence Setting Facility Modifier None Typical Low $147.91 Median $229.09 Typical High $707.95 | Facility | None | $147.91 | $229.09 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $346.74 Typical High $524.81 | Professional | None | $79.43 | $346.74 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,244.36 Typical High $8,128.31 | Facility | None | $5,248.07 | $7,244.36 | $8,128.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $524.81 | Professional | None | $316.23 | $380.19 | $524.81 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $575.44 | Professional | None | $251.19 | $371.54 | $575.44 |
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 $107.15 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $107.15 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | 53 · Discontinued | $43.65 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 54 · Surgery only | $162.18 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $107.15 | $107.15 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | 53 · Discontinued | $43.65 | $43.65 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 54 · Surgery only | $162.18 | $162.18 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $25.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $173.78 |
Where Oregon sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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
$347
OK $891FL $182
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.