How much rates vary
Facilitymedian $204 · 10th to 90th $132 to $692Professionalmedian $182 · 10th to 90th $107 to $309
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 $91.20 Median $123.03 Typical High $165.96 | Professional | None | $91.20 | $123.03 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $660.69 | Facility | None | $131.83 | $165.96 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $323.59 | Professional | None | $131.83 | $199.53 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $295.12 | Professional | None | $162.18 | $223.87 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $7,943.28 | Facility | None | $165.96 | $223.87 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $239.88 | Professional | None | $97.72 | $154.88 | $239.88 |
Pacific Source Setting Facility Modifier None Typical Low $128.82 Median $204.17 Typical High $234.42 | Facility | None | $128.82 | $204.17 | $234.42 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $186.21 Typical High $707.95 | Facility | None | $131.83 | $186.21 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $316.23 | Professional | None | $79.43 | $199.53 | $316.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $851.14 Typical High $1,047.13 | Facility | None | $691.83 | $851.14 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $309.03 | Professional | None | $169.82 | $223.87 | $309.03 |
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 $141.25 Median $208.93 Typical High $338.84 | Professional | None | $141.25 | $208.93 | $338.84 |
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 $61.66 Median $61.66 Typical High $83.18 | Professional | 52 · Reduced service | $61.66 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | 53 · Discontinued | $24.55 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | 54 · Surgery only | $91.20 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $25.12 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | 52 · Reduced service | $61.66 | $61.66 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | 53 · Discontinued | $24.55 | $24.55 | $33.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | 54 · Surgery only | $91.20 | $91.20 | $125.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $25.12 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $16.60 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $117.49 |
Where Oregon sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 6th of 51
$200
AK $355PA $107
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.