How much rates vary
Facilitymedian $275 · 10th to 90th $174 to $3,890Professionalmedian $245 · 10th to 90th $132 to $447
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $190.55 | Professional | None | $117.49 | $144.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $186.21 Typical High $870.96 | Facility | None | $147.91 | $186.21 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $457.09 | Professional | None | $162.18 | $269.15 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $389.05 | Professional | None | $190.55 | $269.15 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $309.03 Typical High $7,943.28 | Facility | None | $186.21 | $309.03 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $363.08 | Professional | None | $131.83 | $190.55 | $363.08 |
Pacific Source Setting Facility Modifier None Typical Low $173.78 Median $275.42 Typical High $323.59 | Facility | None | $173.78 | $275.42 | $323.59 |
Providence Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $831.76 | Facility | None | $147.91 | $204.17 | $831.76 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $251.19 Typical High $446.68 | Professional | None | $79.43 | $251.19 | $446.68 |
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 $218.78 Median $323.59 Typical High $457.09 | Professional | None | $218.78 | $323.59 | $457.09 |
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 $173.78 Median $281.84 Typical High $489.78 | Professional | None | $173.78 | $281.84 | $489.78 |
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 $66.07 Median $72.44 Typical High $95.50 | Professional | 52 · Reduced service | $66.07 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.84 Typical High $38.90 | Professional | 53 · Discontinued | $26.30 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $144.54 | Professional | 54 · Surgery only | $97.72 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.88 Typical High $28.84 | Professional | 55 · Aftercare only | $19.50 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.45 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.18 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $100.00 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $91.20 | $100.00 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $66.07 Typical High $95.50 | Professional | 52 · Reduced service | $66.07 | $66.07 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $38.90 | Professional | 53 · Discontinued | $26.30 | $26.30 | $38.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $144.54 | Professional | 54 · Surgery only | $97.72 | $97.72 | $144.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $28.84 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $28.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $19.05 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $93.33 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $91.20 | $93.33 | $134.90 |
Where Oregon sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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
$263
WI $468TX $129
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.