How much rates vary
Facilitymedian $186 · 10th to 90th $110 to $661Professionalmedian $155 · 10th to 90th $95 to $251
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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $169.82 | Professional | None | $95.50 | $123.03 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $275.42 | Professional | None | $85.11 | $144.54 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $234.42 | Professional | None | $147.91 | $190.55 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $213.80 Typical High $7,943.28 | Facility | None | $123.03 | $213.80 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $218.78 | Professional | None | $102.33 | $147.91 | $218.78 |
Pacific Source Setting Facility Modifier None Typical Low $104.71 Median $173.78 Typical High $208.93 | Facility | None | $104.71 | $173.78 | $208.93 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $199.53 Typical High $338.84 | Facility | None | $97.72 | $199.53 | $338.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $257.04 | Professional | None | $79.43 | $162.18 | $257.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,621.81 | Facility | None | $1,023.29 | $1,380.38 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $213.80 | Professional | None | $151.36 | $186.21 | $213.80 |
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 $123.03 Median $169.82 Typical High $275.42 | Professional | None | $123.03 | $169.82 | $275.42 |
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 $60.26 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $30.20 | Professional | 53 · Discontinued | $23.99 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $91.20 Typical High $112.20 | Professional | 54 · Surgery only | $89.13 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $22.39 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $85.11 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $83.18 | $85.11 | $104.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $60.26 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $24.55 | $30.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 54 · Surgery only | $91.20 | $91.20 | $112.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $22.39 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $22.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $15.14 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $104.71 |
Where Oregon sits
The same service costs 4.2 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· 7th of 51
$166
AK $324FL $77.62
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.