How much rates vary
Facilitymedian $257 · 10th to 90th $155 to $676Professionalmedian $219 · 10th to 90th $129 to $380
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 $114.82 Median $151.36 Typical High $204.17 | Professional | None | $114.82 | $151.36 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $407.38 | Professional | None | $162.18 | $245.47 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $354.81 | Professional | None | $190.55 | $257.04 | $354.81 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $281.84 Typical High $7,943.28 | Facility | None | $181.97 | $281.84 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $288.40 | Professional | None | $123.03 | $190.55 | $288.40 |
Pacific Source Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $288.40 | Facility | None | $154.88 | $251.19 | $288.40 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $257.04 Typical High $562.34 | Facility | None | $100.00 | $257.04 | $562.34 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $245.47 Typical High $389.05 | Professional | None | $79.43 | $245.47 | $389.05 |
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 $204.17 Median $275.42 Typical High $380.19 | Professional | None | $204.17 | $275.42 | $380.19 |
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 $162.18 Median $257.04 Typical High $426.58 | Professional | None | $162.18 | $257.04 | $426.58 |
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 $75.86 Median $75.86 Typical High $102.33 | Professional | 52 · Reduced service | $75.86 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $41.69 | Professional | 53 · Discontinued | $30.20 | $30.20 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | 54 · Surgery only | $114.82 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $30.90 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | 52 · Reduced service | $75.86 | $75.86 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $41.69 | Professional | 53 · Discontinued | $30.20 | $30.20 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | 54 · Surgery only | $114.82 | $114.82 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $30.90 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $20.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $144.54 |
Where Oregon sits
The same service costs 4.2 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
$240
AK $437KY $105
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.