How much rates vary
Facilitymedian $977 · 10th to 90th $589 to $5,129Professionalmedian $1,122 · 10th to 90th $66 to $1,905
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 $1,230.27 Median $11,220.18 Typical High $21,877.62 | Facility | None | $1,230.27 | $11,220.18 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,230.27 | $1,862.09 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $6,025.60 | Facility | None | $660.69 | $660.69 | $6,025.60 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $7,943.28 | Professional | None | $1,348.96 | $2,454.71 | $7,943.28 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $776.25 Typical High $2,137.96 | Facility | None | $707.95 | $776.25 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,318.26 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,445.44 | $2,041.74 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $1,023.29 Typical High $1,862.09 | Professional | None | $63.10 | $1,023.29 | $1,862.09 |
Pacific Source Setting Facility Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,089.30 | Facility | None | $1,445.44 | $1,819.70 | $2,089.30 |
Premera BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Premera BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,905.46 | $2,754.23 |
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 $1,258.93 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,737.80 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,230.27 | $1,778.28 |
4 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 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $954.99 | Professional | 54 · Surgery only | $933.25 | $933.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $194.98 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $891.25 |
Where Washington sits
The same service costs 9.4 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 $15,900MD $1,684
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.