How much rates vary
Facilitymedian $275 · 10th to 90th $166 to $912Professionalmedian $229 · 10th to 90th $115 to $372
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 $223.87 Median $4,786.30 Typical High $7,943.28 | Facility | None | $223.87 | $4,786.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $257.04 | Professional | None | $114.82 | $181.97 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $186.21 Typical High $263.03 | Facility | None | $104.71 | $186.21 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $398.11 | Professional | None | $114.82 | $213.80 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $346.74 | Professional | None | $204.17 | $269.15 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $331.13 Typical High $6,606.93 | Facility | None | $223.87 | $331.13 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $346.74 | Professional | None | $114.82 | $204.17 | $346.74 |
Pacific Source Setting Facility Modifier None Typical Low $169.82 Median $275.42 Typical High $295.12 | Facility | None | $169.82 | $275.42 | $295.12 |
Providence Setting Facility Modifier None Typical Low $154.88 Median $218.78 Typical High $371.54 | Facility | None | $154.88 | $218.78 | $371.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $223.87 Typical High $380.19 | Professional | None | $79.43 | $223.87 | $380.19 |
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 $223.87 Median $275.42 Typical High $323.59 | Professional | None | $223.87 | $275.42 | $323.59 |
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 $177.83 Median $257.04 Typical High $407.38 | Professional | None | $177.83 | $257.04 | $407.38 |
14 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 $89.13 Median $91.20 Typical High $117.49 | Professional | 52 · Reduced service | $89.13 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $36.31 Typical High $46.77 | Professional | 53 · Discontinued | $35.48 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $138.04 Typical High $177.83 | Professional | 54 · Surgery only | $134.90 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.20 Typical High $23.44 | Professional | 56 · Pre-op care only | $17.78 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $128.82 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $125.89 | $128.82 | $165.96 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $245.47 Typical High $645.65 | Professional | 50 · Both sides | $173.78 | $245.47 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $91.20 Typical High $117.49 | Professional | 52 · Reduced service | $91.20 | $91.20 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $46.77 | Professional | 53 · Discontinued | $36.31 | $36.31 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $177.83 | Professional | 54 · Surgery only | $138.04 | $138.04 | $177.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $23.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $165.96 |
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 4.1 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· 8th of 51
$234
AK $468FL $115
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.