How much rates vary
Facilitymedian $437 · 10th to 90th $275 to $5,623Professionalmedian $316 · 10th to 90th $158 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 $3,890.45 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 $144.54 Median $229.09 Typical High $380.19 | Professional | None | $144.54 | $229.09 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $363.08 Typical High $660.69 | Facility | None | $288.40 | $363.08 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $323.59 Typical High $645.65 | Professional | None | $154.88 | $323.59 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $588.84 | Professional | None | $245.47 | $354.81 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $549.54 Typical High $7,943.28 | Facility | None | $302.00 | $549.54 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $512.86 | Professional | None | $158.49 | $288.40 | $512.86 |
Pacific Source Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $478.63 | Facility | None | $269.15 | $426.58 | $478.63 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $380.19 Typical High $660.69 | Facility | None | $288.40 | $380.19 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $309.03 Typical High $562.34 | Professional | None | $79.43 | $309.03 | $562.34 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $8,128.31 Typical High $9,332.54 | Facility | None | $5,754.40 | $8,128.31 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $478.63 | Professional | None | $281.84 | $407.38 | $478.63 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $645.65 | Professional | None | $234.42 | $380.19 | $645.65 |
13 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 $112.20 Median $114.82 Typical High $190.55 | Professional | 52 · Reduced service | $112.20 | $114.82 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $75.86 | Professional | 53 · Discontinued | $45.71 | $45.71 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $288.40 | Professional | 54 · Surgery only | $169.82 | $169.82 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $57.54 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.91 Typical High $38.02 | Professional | 56 · Pre-op care only | $22.39 | $22.91 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $131.83 Typical High $190.55 | Professional | 52 · Reduced service | $114.82 | $131.83 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $75.86 | Professional | 53 · Discontinued | $45.71 | $52.48 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $194.98 Typical High $288.40 | Professional | 54 · Surgery only | $169.82 | $194.98 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.90 Typical High $57.54 | Professional | 55 · Aftercare only | $33.88 | $38.90 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $38.02 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $38.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $181.97 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $158.49 | $181.97 | $269.15 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,709.64 Median $12,302.69 Typical High $13,803.84 | Facility | 50 · Both sides | $8,709.64 | $12,302.69 | $13,803.84 |
Where Oregon sits
The same service costs 4.2 times more in Wyoming 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
$380
WY $692UT $166
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.