How much rates vary
Facilitymedian $302 · 10th to 90th $182 to $5,012Professionalmedian $269 · 10th to 90th $132 to $437
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 $138.04 Median $229.09 Typical High $245.47 | Professional | None | $138.04 | $229.09 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $194.98 Typical High $660.69 | Facility | None | $151.36 | $194.98 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $446.68 | Professional | None | $123.03 | $257.04 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $389.05 | Professional | None | $245.47 | $316.23 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $7,943.28 | Facility | None | $251.19 | $407.38 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $407.38 | Professional | None | $154.88 | $245.47 | $407.38 |
Pacific Source Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $316.23 | Facility | None | $181.97 | $295.12 | $316.23 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $251.19 Typical High $660.69 | Facility | None | $158.49 | $251.19 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $275.42 Typical High $436.52 | Professional | None | $79.43 | $275.42 | $436.52 |
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 $302.00 Typical High $389.05 | Professional | None | $281.84 | $302.00 | $389.05 |
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 $213.80 Median $281.84 Typical High $512.86 | Professional | None | $213.80 | $281.84 | $512.86 |
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 $102.33 Median $114.82 Typical High $123.03 | Professional | 52 · Reduced service | $102.33 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $48.98 | Professional | 53 · Discontinued | $40.74 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $173.78 Typical High $181.97 | Professional | 54 · Surgery only | $151.36 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $34.67 Typical High $37.15 | Professional | 55 · Aftercare only | $30.20 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $162.18 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $141.25 | $162.18 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $114.82 Typical High $123.03 | Professional | 52 · Reduced service | $114.82 | $114.82 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | 53 · Discontinued | $45.71 | $45.71 | $48.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | 54 · Surgery only | $173.78 | $173.78 | $181.97 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $37.15 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $24.55 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $24.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $169.82 |
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 4.6 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· 9th of 51
$282
AK $603FL $132
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.