How much rates vary
Facilitymedian $407 · 10th to 90th $224 to $1,549Professionalmedian $324 · 10th to 90th $174 to $575
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $323.59 | Professional | None | $131.83 | $199.53 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $331.13 Typical High $870.96 | Facility | None | $263.03 | $331.13 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $616.60 | Professional | None | $204.17 | $338.84 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $537.03 | Professional | None | $245.47 | $354.81 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $478.63 Typical High $7,943.28 | Facility | None | $281.84 | $478.63 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $436.52 | Professional | None | $158.49 | $257.04 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $239.88 Median $407.38 Typical High $436.52 | Facility | None | $239.88 | $407.38 | $436.52 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $338.84 Typical High $691.83 | Facility | None | $245.47 | $338.84 | $691.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $338.84 Typical High $602.56 | Professional | None | $79.43 | $338.84 | $602.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,187.76 | Facility | None | $1,318.26 | $1,819.70 | $2,187.76 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $588.84 | Professional | None | $263.03 | $416.87 | $588.84 |
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 $218.78 Median $371.54 Typical High $616.60 | Professional | None | $218.78 | $371.54 | $616.60 |
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 $100.00 Median $100.00 Typical High $162.18 | Professional | 52 · Reduced service | $100.00 | $100.00 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $66.07 | Professional | 53 · Discontinued | $39.81 | $39.81 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $245.47 | Professional | 54 · Surgery only | $147.91 | $147.91 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $48.98 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $138.04 | $138.04 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $100.00 Typical High $162.18 | Professional | 52 · Reduced service | $100.00 | $100.00 | $162.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $66.07 | Professional | 53 · Discontinued | $39.81 | $39.81 | $66.07 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $245.47 | Professional | 54 · Surgery only | $147.91 | $147.91 | $245.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $48.98 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $48.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $32.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $138.04 | $138.04 | $229.09 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $1,949.84 Median $2,691.53 Typical High $3,311.31 | Facility | 50 · Both sides | $1,949.84 | $2,691.53 | $3,311.31 |
Where Oregon sits
The same service costs 3.5 times more in Wisconsin 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
$355
WI $575KY $162
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.