How much rates vary
Facilitymedian $275 · 10th to 90th $155 to $1,122Professionalmedian $240 · 10th to 90th $148 to $398
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 $120.23 Median $158.49 Typical High $218.78 | Professional | None | $120.23 | $158.49 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $154.88 Typical High $245.47 | Facility | None | $114.82 | $154.88 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $398.11 | Professional | None | $154.88 | $218.78 | $398.11 |
HealthNet Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $389.05 | Professional | None | $208.93 | $281.84 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $3,090.30 Typical High $6,606.93 | Facility | None | $223.87 | $3,090.30 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $426.58 | Professional | None | $131.83 | $204.17 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $173.78 Median $275.42 Typical High $309.03 | Facility | None | $173.78 | $275.42 | $309.03 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $338.84 | Facility | None | $125.89 | $158.49 | $338.84 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $398.11 | Professional | None | $120.23 | $251.19 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,174.90 | Facility | None | $776.25 | $1,023.29 | $1,174.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $346.74 | Professional | None | $234.42 | $295.12 | $346.74 |
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 $169.82 Median $251.19 Typical High $416.87 | Professional | None | $169.82 | $251.19 | $416.87 |
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 $79.43 Median $79.43 Typical High $102.33 | Professional | 52 · Reduced service | $79.43 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $40.74 | Professional | 53 · Discontinued | $31.62 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $141.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $102.33 | Professional | 52 · Reduced service | $79.43 | $79.43 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $40.74 | Professional | 53 · Discontinued | $31.62 | $31.62 | $40.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $120.23 | $120.23 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $20.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $141.25 |
Where Oregon sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 10th of 51
$245
AK $501FL $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.