How much rates vary
Facilitymedian $2,291 · 10th to 90th $617 to $9,772Professionalmedian $955 · 10th to 90th $138 to $7,943
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 $4,265.80 Typical High $9,772.37 | Facility | None | $1,288.25 | $4,265.80 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $5,248.07 | Professional | None | $1,122.02 | $1,258.93 | $5,248.07 |
BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $2,290.87 Typical High $8,709.64 | Facility | None | $1,202.26 | $2,290.87 | $8,709.64 |
BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,288.25 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $3,235.94 | Facility | None | $630.96 | $1,258.93 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,445.44 | $1,949.84 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $9,120.11 Typical High $9,120.11 | Professional | None | $7,943.28 | $9,120.11 | $9,120.11 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $2,951.21 Typical High $8,511.38 | Facility | None | $1,023.29 | $2,951.21 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,258.93 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $741.31 Typical High $1,071.52 | Professional | None | $117.49 | $741.31 | $1,071.52 |
Oscar Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $4,168.69 | Professional | None | $3,715.35 | $3,801.89 | $4,168.69 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $251,188.64 | Facility | None | $758.58 | $1,513.56 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,445.44 | $1,949.84 |
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 $912.01 Median $1,318.26 Typical High $1,995.26 | Professional | None | $912.01 | $1,318.26 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $562.34 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $562.34 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $223.87 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $831.76 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $112.20 | $123.03 | $141.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $616.60 Typical High $691.83 | Professional | 52 · Reduced service | $562.34 | $616.60 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $223.87 | $245.47 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $831.76 | $933.25 | $1,047.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $123.03 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $123.03 | $138.04 |
Where Texas sits
The same service costs 15.0 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 $27,402MD $1,821
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.