How much rates vary
Facilitymedian $2,239 · 10th to 90th $912 to $7,943Professionalmedian $2,089 · 10th to 90th $1,047 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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $23,988.33 | Facility | None | $549.54 | $1,000.00 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,380.38 | $1,862.09 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,778.28 | $2,238.72 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,621.81 Median $2,754.23 Typical High $7,943.28 | Facility | None | $1,621.81 | $2,754.23 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,621.81 | $1,778.28 | $2,754.23 |
Pacific Source Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $2,344.23 | Facility | None | $1,348.96 | $2,089.30 | $2,344.23 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,023.29 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,137.96 Typical High $3,388.44 | Professional | None | $79.43 | $2,137.96 | $3,388.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,344.23 | $3,090.30 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,137.96 | $3,630.78 |
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 $588.84 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $588.84 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $234.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $870.96 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $173.78 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $117.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $812.83 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $741.31 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $295.12 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,122.02 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $223.87 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $147.91 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,122.02 | $1,122.02 |
Where Oregon sits
The same service costs 9.8 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 $17,362MD $1,765
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.