How much rates vary
Facilitymedian $355 · 10th to 90th $214 to $1,950Professionalmedian $282 · 10th to 90th $151 to $501
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 $398.11 Median $5,011.87 Typical High $7,943.28 | Facility | None | $398.11 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $281.84 | Professional | None | $112.20 | $177.83 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $269.15 Typical High $371.54 | Facility | None | $147.91 | $269.15 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $524.81 | Professional | None | $186.21 | $302.00 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $467.74 | Professional | None | $229.09 | $323.59 | $467.74 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $6,606.93 | Facility | None | $251.19 | $407.38 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $389.05 | Professional | None | $131.83 | $229.09 | $389.05 |
Pacific Source Setting Facility Modifier None Typical Low $213.80 Median $338.84 Typical High $380.19 | Facility | None | $213.80 | $338.84 | $380.19 |
Providence Setting Facility Modifier None Typical Low $177.83 Median $281.84 Typical High $457.09 | Facility | None | $177.83 | $281.84 | $457.09 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $302.00 Typical High $501.19 | Professional | None | $79.43 | $302.00 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $2,818.38 | Facility | None | $1,819.70 | $2,454.71 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $501.19 | Professional | None | $239.88 | $354.81 | $501.19 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,630.78 | Facility | None | $354.81 | $660.69 | $3,630.78 |
United Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $524.81 | Professional | None | $199.53 | $331.13 | $524.81 |
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 $89.13 Median $89.13 Typical High $141.25 | Professional | 52 · Reduced service | $89.13 | $89.13 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $56.23 | Professional | 53 · Discontinued | $35.48 | $35.48 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $213.80 | Professional | 54 · Surgery only | $134.90 | $134.90 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $42.66 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $28.18 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $89.13 Typical High $141.25 | Professional | 52 · Reduced service | $89.13 | $89.13 | $141.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $56.23 | Professional | 53 · Discontinued | $35.48 | $35.48 | $56.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $213.80 | Professional | 54 · Surgery only | $134.90 | $134.90 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $42.66 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $42.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $28.18 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $28.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $199.53 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $2,754.23 Median $3,630.78 Typical High $4,168.69 | Facility | 50 · Both sides | $2,754.23 | $3,630.78 | $4,168.69 |
Where Oregon sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$302
AK $513KY $126
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.