How much rates vary
Facilitymedian $2,692 · 10th to 90th $550 to $10,471Professionalmedian $339 · 10th to 90th $45 to $2,692
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 $1,122.02 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,290.87 | $2,884.03 |
BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $4,073.80 Typical High $9,120.11 | Facility | None | $2,290.87 | $4,073.80 | $9,120.11 |
BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,995.26 | $2,089.30 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $2,691.53 | Facility | None | $630.96 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,630.78 | Professional | None | $2,137.96 | $2,398.83 | $3,630.78 |
Lucent Health Setting Professional Modifier None Typical Low $15,848.93 Median $15,848.93 Typical High $16,595.87 | Professional | None | $15,848.93 | $15,848.93 | $16,595.87 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,818.38 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $3,019.95 | Professional | None | $2,089.30 | $2,290.87 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $281.84 Typical High $1,778.28 | Professional | None | $39.81 | $281.84 | $1,778.28 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,187.76 Typical High $251,188.64 | Facility | None | $812.83 | $2,187.76 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,630.78 | Professional | None | $2,137.96 | $2,398.83 | $3,630.78 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,290.87 | $3,467.37 |
Wellpoint Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,047.13 Median $1,148.15 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,047.13 | $1,148.15 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $457.09 Typical High $512.86 | Professional | 53 · Discontinued | $426.58 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,737.80 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,584.89 | $1,737.80 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $346.74 Typical High $389.05 | Professional | 55 · Aftercare only | $316.23 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $229.09 Typical High $257.04 | Professional | 56 · Pre-op care only | $208.93 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,621.81 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,621.81 | $1,819.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,148.15 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,047.13 | $1,148.15 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $457.09 Typical High $501.19 | Professional | 53 · Discontinued | $426.58 | $457.09 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,737.80 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,584.89 | $1,737.80 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $346.74 Typical High $380.19 | Professional | 55 · Aftercare only | $316.23 | $346.74 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $229.09 Typical High $251.19 | Professional | 56 · Pre-op care only | $208.93 | $229.09 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,621.81 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,621.81 | $1,778.28 |
Where Texas sits
The same service costs 11.5 times more in Maine than in Washington. 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.
Physician feeFacility fee
ME $29,935WA $2,608
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.