How much rates vary
Facilitymedian $1,995 · 10th to 90th $501 to $10,471Professionalmedian $229 · 10th to 90th $28 to $1,698
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 $1,230.27 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,348.96 | $1,698.24 |
BCBS Texas Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,513.56 | $2,818.38 |
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 $1,288.25 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,479.11 | $2,238.72 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $10,964.78 | Professional | None | $9,120.11 | $9,120.11 | $10,964.78 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,137.96 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,137.96 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,348.96 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $181.97 Typical High $1,174.90 | Professional | None | $26.30 | $181.97 | $1,174.90 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,698.24 Typical High $251,188.64 | Facility | None | $812.83 | $1,698.24 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,479.11 | $2,238.72 |
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 $1,047.13 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,412.54 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $616.60 Median $676.08 Typical High $776.25 | Professional | 52 · Reduced service | $616.60 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $154.88 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $676.08 Typical High $741.31 | Professional | 52 · Reduced service | $616.60 | $676.08 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $302.00 | Professional | 53 · Discontinued | $251.19 | $269.15 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $223.87 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $147.91 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $147.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $1,047.13 |
Where Texas sits
The same service costs 14.4 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 $28,777WA $2,000
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.