How much rates vary
Facilitymedian $479 · 10th to 90th $316 to $2,455Professionalmedian $389 · 10th to 90th $257 to $617
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 $257.04 Median $257.04 Typical High $346.74 | Professional | None | $257.04 | $257.04 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $933.25 Typical High $1,230.27 | Facility | None | $707.95 | $933.25 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $630.96 | Professional | None | $269.15 | $380.19 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $691.83 | Professional | None | $363.08 | $489.78 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $7,943.28 | Facility | None | $346.74 | $501.19 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $537.03 | Professional | None | $257.04 | $346.74 | $537.03 |
Pacific Source Setting Facility Modifier None Typical Low $281.84 Median $436.52 Typical High $512.86 | Facility | None | $281.84 | $436.52 | $512.86 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $831.76 Typical High $1,230.27 | Facility | None | $380.19 | $831.76 | $1,230.27 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $398.11 Typical High $630.96 | Professional | None | $79.43 | $398.11 | $630.96 |
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 $363.08 Median $489.78 Typical High $549.54 | Professional | None | $363.08 | $489.78 | $549.54 |
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 $275.42 Median $398.11 Typical High $676.08 | Professional | None | $275.42 | $398.11 | $676.08 |
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 $128.82 Median $128.82 Typical High $173.78 | Professional | 52 · Reduced service | $128.82 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $51.29 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $52.48 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | 52 · Reduced service | $128.82 | $128.82 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $51.29 | $51.29 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $194.98 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $52.48 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $34.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $245.47 |
Where Oregon sits
The same service costs 4.3 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· 9th of 51
$407
AK $912KY $214
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.