How much rates vary
Facilitymedian $240 · 10th to 90th $158 to $1,318Professionalmedian $209 · 10th to 90th $112 to $363
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 $95.50 Median $134.90 Typical High $194.98 | Professional | None | $95.50 | $134.90 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $190.55 Typical High $870.96 | Facility | None | $154.88 | $190.55 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $389.05 | Professional | None | $144.54 | $229.09 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $338.84 | Professional | None | $169.82 | $234.42 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $251.19 Typical High $7,943.28 | Facility | None | $177.83 | $251.19 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $263.03 | Professional | None | $104.71 | $162.18 | $263.03 |
Pacific Source Setting Facility Modifier None Typical Low $144.54 Median $229.09 Typical High $275.42 | Facility | None | $144.54 | $229.09 | $275.42 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $208.93 Typical High $691.83 | Facility | None | $144.54 | $208.93 | $691.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $371.54 | Professional | None | $79.43 | $218.78 | $371.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $7,413.10 | Facility | None | $4,786.30 | $6,456.54 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $363.08 | Professional | None | $186.21 | $263.03 | $363.08 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $398.11 | Professional | None | $144.54 | $234.42 | $398.11 |
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 $67.61 Median $67.61 Typical High $97.72 | Professional | 52 · Reduced service | $67.61 | $67.61 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $38.90 | Professional | 53 · Discontinued | $27.54 | $27.54 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | 54 · Surgery only | $102.33 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $29.51 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $95.50 | $95.50 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $67.61 Typical High $97.72 | Professional | 52 · Reduced service | $67.61 | $67.61 | $97.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $38.90 | Professional | 53 · Discontinued | $27.54 | $27.54 | $38.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | 54 · Surgery only | $102.33 | $102.33 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $29.51 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $29.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $19.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $95.50 | $95.50 | $138.04 |
Where Oregon sits
The same service costs 3.5 times more in Wisconsin 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
$229
WI $398KY $115
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.