How much rates vary
Facilitymedian $1,023 · 10th to 90th $589 to $3,311Professionalmedian $1,318 · 10th to 90th $120 to $3,162
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 $2,041.74 Median $7,943.28 Typical High $27,542.29 | Facility | None | $2,041.74 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $2,137.96 | Professional | None | $1,659.59 | $2,041.74 | $2,137.96 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $1,122.02 Typical High $10,000.00 | Facility | None | $30.20 | $1,122.02 | $10,000.00 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $2,238.72 Median $4,168.69 Typical High $13,182.57 | Professional | None | $2,238.72 | $4,168.69 | $13,182.57 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $891.25 Typical High $2,691.53 | Facility | None | $707.95 | $891.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $4,570.88 | Professional | None | $1,995.26 | $2,187.76 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $3,388.44 Typical High $4,365.16 | Professional | None | $2,290.87 | $3,388.44 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $1,122.02 Typical High $3,019.95 | Professional | None | $114.82 | $1,122.02 | $3,019.95 |
Pacific Source Setting Facility Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,311.31 | Facility | None | $2,630.27 | $3,090.30 | $3,311.31 |
Premera BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Premera BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,238.72 Median $3,235.94 Typical High $4,570.88 | Professional | None | $2,238.72 | $3,235.94 | $4,570.88 |
United Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $1,584.89 | Facility | None | $524.81 | $758.58 | $1,584.89 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $5,011.87 | Professional | None | $2,089.30 | $2,884.03 | $5,011.87 |
Wellpoint Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,995.26 | $2,089.30 | $2,951.21 |
6 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 $1,023.29 Median $1,023.29 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | 53 · Discontinued | $407.38 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $213.80 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,479.11 |
Where Washington sits
The same service costs 7.1 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 $16,524WA $2,342
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.