How much rates vary
Facilitymedian $468 · 10th to 90th $302 to $2,399Professionalmedian $347 · 10th to 90th $219 to $562
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 $218.78 Median $218.78 Typical High $346.74 | Professional | None | $218.78 | $218.78 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $933.25 Typical High $1,230.27 | Facility | None | $537.03 | $933.25 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $588.84 | Professional | None | $229.09 | $354.81 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $630.96 | Professional | None | $269.15 | $398.11 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $537.03 Typical High $6,606.93 | Facility | None | $309.03 | $537.03 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $512.86 | Professional | None | $218.78 | $346.74 | $512.86 |
Pacific Source Setting Facility Modifier None Typical Low $275.42 Median $457.09 Typical High $478.63 | Facility | None | $275.42 | $457.09 | $478.63 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $776.25 Typical High $1,230.27 | Facility | None | $346.74 | $776.25 | $1,230.27 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $354.81 Typical High $588.84 | Professional | None | $79.43 | $354.81 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $3,630.78 | Facility | None | $2,290.87 | $3,162.28 | $3,630.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $478.63 | Professional | None | $295.12 | $446.68 | $478.63 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $630.96 | Professional | None | $234.42 | $371.54 | $630.96 |
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 $109.65 Median $109.65 Typical High $169.82 | Professional | 52 · Reduced service | $109.65 | $109.65 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $69.18 | Professional | 53 · Discontinued | $43.65 | $43.65 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $257.04 | Professional | 54 · Surgery only | $162.18 | $162.18 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $51.29 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $109.65 Typical High $169.82 | Professional | 52 · Reduced service | $109.65 | $109.65 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $69.18 | Professional | 53 · Discontinued | $43.65 | $43.65 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $257.04 | Professional | 54 · Surgery only | $162.18 | $162.18 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $51.29 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $34.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $239.88 |
Where Oregon sits
The same service costs 4.2 times more in Alaska than in Virginia. 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
$389
AK $776VA $186
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.