How much rates vary
Facilitymedian $2,399 · 10th to 90th $575 to $10,965Professionalmedian $1,000 · 10th to 90th $66 to $9,333
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 $1,288.25 Median $3,981.07 Typical High $10,471.29 | Facility | None | $1,288.25 | $3,981.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $5,495.41 | Professional | None | $1,318.26 | $1,513.56 | $5,495.41 |
BCBS Texas Setting Facility Modifier None Typical Low $1,445.44 Median $2,691.53 Typical High $7,079.46 | Facility | None | $1,445.44 | $2,691.53 | $7,079.46 |
BCBS Texas Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,548.82 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $10,964.78 | Facility | None | $630.96 | $1,258.93 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,698.24 | $2,344.23 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $10,964.78 Typical High $10,964.78 | Professional | None | $9,332.54 | $10,964.78 | $10,964.78 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,818.38 | $7,585.78 |
Moda Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,513.56 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $18.62 Median $199.53 Typical High $1,230.27 | Professional | None | $18.62 | $199.53 | $1,230.27 |
Oscar Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,466.84 Typical High $4,897.79 | Professional | None | $4,365.16 | $4,466.84 | $4,897.79 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,584.89 Typical High $251,188.64 | Facility | None | $758.58 | $1,584.89 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,698.24 | $2,344.23 |
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 $1,096.48 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,584.89 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
10 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 $660.69 Median $741.31 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $295.12 Typical High $338.84 | Professional | 53 · Discontinued | $263.03 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $251.19 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $741.31 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $741.31 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $295.12 Typical High $338.84 | Professional | 53 · Discontinued | $263.03 | $295.12 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $251.19 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $165.96 |
Where Texas sits
The same service costs 25.6 times more in Maine than in Maryland. 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 $53,236MD $2,076
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.