How much rates vary
Facilitymedian $794 · 10th to 90th $316 to $1,023Professionalmedian $575 · 10th to 90th $302 to $1,023
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 $275.42 Median $389.05 Typical High $707.95 | Professional | None | $275.42 | $389.05 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $338.84 Typical High $478.63 | Facility | None | $190.55 | $338.84 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $575.44 Typical High $1,174.90 | Professional | None | $263.03 | $575.44 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $1,071.52 | Professional | None | $407.38 | $588.84 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $6,606.93 | Facility | None | $537.03 | $1,000.00 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $831.76 | Professional | None | $338.84 | $562.34 | $831.76 |
Pacific Source Setting Facility Modifier None Typical Low $489.78 Median $812.83 Typical High $870.96 | Facility | None | $489.78 | $812.83 | $870.96 |
Providence Setting Facility Modifier None Typical Low $281.84 Median $398.11 Typical High $1,023.29 | Facility | None | $281.84 | $398.11 | $1,023.29 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $1,023.29 | Professional | None | $79.43 | $562.34 | $1,023.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,202.26 | Facility | None | $812.83 | $1,023.29 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $870.96 | Professional | None | $478.63 | $724.44 | $870.96 |
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 $407.38 Median $691.83 Typical High $1,202.26 | Professional | None | $407.38 | $691.83 | $1,202.26 |
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 $194.98 Median $204.17 Typical High $354.81 | Professional | 52 · Reduced service | $194.98 | $204.17 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $141.25 | Professional | 53 · Discontinued | $77.62 | $81.28 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $302.00 Typical High $524.81 | Professional | 54 · Surgery only | $288.40 | $302.00 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $104.71 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $70.79 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $239.88 Typical High $354.81 | Professional | 52 · Reduced service | $194.98 | $239.88 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $95.50 Typical High $141.25 | Professional | 53 · Discontinued | $77.62 | $95.50 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $363.08 Typical High $524.81 | Professional | 54 · Surgery only | $288.40 | $363.08 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $72.44 Typical High $104.71 | Professional | 55 · Aftercare only | $58.88 | $72.44 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $47.86 Typical High $70.79 | Professional | 56 · Pre-op care only | $38.90 | $47.86 | $70.79 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $338.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $269.15 | $338.84 | $489.78 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $1,202.26 Median $1,548.82 Typical High $1,819.70 | Facility | 50 · Both sides | $1,202.26 | $1,548.82 | $1,819.70 |
Where Oregon sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$661
AK $1,023MD $302
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.