How much rates vary
Facilitymedian $447 · 10th to 90th $269 to $4,786Professionalmedian $380 · 10th to 90th $209 to $661
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 $173.78 Median $218.78 Typical High $288.40 | Professional | None | $173.78 | $218.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,235.94 Typical High $4,466.84 | Facility | None | $660.69 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $691.83 | Professional | None | $269.15 | $407.38 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $575.44 | Professional | None | $316.23 | $436.52 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $467.74 Typical High $6,606.93 | Facility | None | $288.40 | $467.74 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $512.86 | Professional | None | $190.55 | $288.40 | $512.86 |
Pacific Source Setting Facility Modifier None Typical Low $257.04 Median $407.38 Typical High $478.63 | Facility | None | $257.04 | $407.38 | $478.63 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $2,630.27 Typical High $4,466.84 | Facility | None | $309.03 | $2,630.27 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $398.11 Typical High $660.69 | Professional | None | $79.43 | $398.11 | $660.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $10,715.19 Typical High $12,589.25 | Facility | None | $7,413.10 | $10,715.19 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $676.08 | Professional | None | $354.81 | $478.63 | $676.08 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $741.31 | Professional | None | $275.42 | $416.87 | $741.31 |
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 $144.54 | Professional | 52 · Reduced service | $107.15 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $57.54 | Professional | 53 · Discontinued | $43.65 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | 54 · Surgery only | $162.18 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $42.66 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 52 · Reduced service | $107.15 | $107.15 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $57.54 | Professional | 53 · Discontinued | $43.65 | $43.65 | $57.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | 54 · Surgery only | $162.18 | $162.18 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $42.66 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $42.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $28.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $199.53 |
Where Oregon sits
The same service costs 4.4 times more in Alaska than in Utah. 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
$407
AK $871UT $200
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.