How much rates vary
Facilitymedian $389 · 10th to 90th $234 to $3,890Professionalmedian $316 · 10th to 90th $191 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 $147.91 Median $208.93 Typical High $316.23 | Professional | None | $147.91 | $208.93 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $331.13 Typical High $870.96 | Facility | None | $269.15 | $331.13 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $602.56 | Professional | None | $194.98 | $323.59 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $512.86 | Professional | None | $234.42 | $338.84 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $457.09 Typical High $7,943.28 | Facility | None | $269.15 | $457.09 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $416.87 | Professional | None | $190.55 | $275.42 | $416.87 |
Pacific Source Setting Facility Modifier None Typical Low $234.42 Median $380.19 Typical High $426.58 | Facility | None | $234.42 | $380.19 | $426.58 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $338.84 Typical High $691.83 | Facility | None | $251.19 | $338.84 | $691.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $323.59 Typical High $575.44 | Professional | None | $79.43 | $323.59 | $575.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $6,025.60 | Facility | None | $3,801.89 | $5,248.07 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $575.44 | Professional | None | $251.19 | $407.38 | $575.44 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $208.93 Median $354.81 Typical High $602.56 | Professional | None | $208.93 | $354.81 | $602.56 |
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 $95.50 Median $95.50 Typical High $158.49 | Professional | 52 · Reduced service | $95.50 | $95.50 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $64.57 | Professional | 53 · Discontinued | $38.02 | $38.02 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $239.88 | Professional | 54 · Surgery only | $141.25 | $141.25 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $47.86 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $158.49 | Professional | 52 · Reduced service | $95.50 | $95.50 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $64.57 | Professional | 53 · Discontinued | $38.02 | $38.02 | $64.57 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $239.88 | Professional | 54 · Surgery only | $141.25 | $141.25 | $239.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $47.86 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $31.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $223.87 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $5,754.40 Median $7,943.28 Typical High $9,120.11 | Facility | 50 · Both sides | $5,754.40 | $7,943.28 | $9,120.11 |
Where Oregon sits
The same service costs 3.9 times more in Oklahoma 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· 7th of 51
$347
OK $646KY $166
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.