How much rates vary
Facilitymedian $245 · 10th to 90th $151 to $832Professionalmedian $214 · 10th to 90th $102 to $347
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 $104.71 Median $181.97 Typical High $218.78 | Professional | None | $104.71 | $181.97 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $173.78 Typical High $245.47 | Facility | None | $100.00 | $173.78 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $204.17 Typical High $380.19 | Professional | None | $100.00 | $204.17 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $331.13 | Professional | None | $204.17 | $257.04 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $309.03 Typical High $6,606.93 | Facility | None | $199.53 | $309.03 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $295.12 | Professional | None | $112.20 | $190.55 | $295.12 |
Pacific Source Setting Facility Modifier None Typical Low $147.91 Median $245.47 Typical High $269.15 | Facility | None | $147.91 | $245.47 | $269.15 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $194.98 Typical High $346.74 | Facility | None | $144.54 | $194.98 | $346.74 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $223.87 Typical High $354.81 | Professional | None | $79.43 | $223.87 | $354.81 |
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 $257.04 Typical High $323.59 | Professional | None | $223.87 | $257.04 | $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 $169.82 Median $229.09 Typical High $407.38 | Professional | None | $169.82 | $229.09 | $407.38 |
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 $87.10 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $87.10 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $34.67 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $128.82 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $17.38 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $125.89 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $120.23 | $125.89 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $91.20 | $91.20 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $36.31 | $36.31 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $134.90 | $134.90 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $20.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $144.54 |
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 4.4 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
$224
AK $468FL $107
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.