How much rates vary
Facilitymedian $316 · 10th to 90th $191 to $4,571Professionalmedian $269 · 10th to 90th $135 to $501
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 $117.49 Median $154.88 Typical High $309.03 | Professional | None | $117.49 | $154.88 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $257.04 Typical High $870.96 | Facility | None | $204.17 | $257.04 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $537.03 | Professional | None | $199.53 | $309.03 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $446.68 | Professional | None | $234.42 | $316.23 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $316.23 Typical High $7,943.28 | Facility | None | $218.78 | $316.23 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $407.38 | Professional | None | $125.89 | $218.78 | $407.38 |
Pacific Source Setting Facility Modifier None Typical Low $181.97 Median $316.23 Typical High $371.54 | Facility | None | $181.97 | $316.23 | $371.54 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $263.03 Typical High $831.76 | Facility | None | $190.55 | $263.03 | $831.76 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $288.40 Typical High $524.81 | Professional | None | $79.43 | $288.40 | $524.81 |
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 $257.04 Median $371.54 Typical High $524.81 | Professional | None | $257.04 | $371.54 | $524.81 |
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 $190.55 Median $302.00 Typical High $549.54 | Professional | None | $190.55 | $302.00 | $549.54 |
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 $77.62 Median $77.62 Typical High $109.65 | Professional | 52 · Reduced service | $77.62 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $44.67 | Professional | 53 · Discontinued | $30.90 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $165.96 | Professional | 54 · Surgery only | $114.82 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $77.62 Typical High $109.65 | Professional | 52 · Reduced service | $77.62 | $77.62 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $44.67 | Professional | 53 · Discontinued | $30.90 | $30.90 | $44.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $165.96 | Professional | 54 · Surgery only | $114.82 | $114.82 | $165.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $21.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $154.88 |
Where Oregon sits
The same service costs 3.9 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
$288
AK $550KY $141
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.