How much rates vary
Facilitymedian $708 · 10th to 90th $355 to $2,138Professionalmedian $316 · 10th to 90th $78 to $589
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 $263.03 Median $7,943.28 Typical High $27,542.29 | Facility | None | $263.03 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $288.40 | Professional | None | $239.88 | $263.03 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $147.91 Typical High $1,288.25 | Facility | None | $30.20 | $147.91 | $1,288.25 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $288.40 Median $537.03 Typical High $2,818.38 | Professional | None | $288.40 | $537.03 | $2,818.38 |
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 $257.04 Median $323.59 Typical High $616.60 | Professional | None | $257.04 | $323.59 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $537.03 | Professional | None | $263.03 | $426.58 | $537.03 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $316.23 Typical High $562.34 | Professional | None | $57.54 | $316.23 | $562.34 |
Pacific Source Setting Facility Modifier None Typical Low $302.00 Median $398.11 Typical High $426.58 | Facility | None | $302.00 | $398.11 | $426.58 |
Premera BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Premera BCBS Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $575.44 | Professional | None | $288.40 | $416.87 | $575.44 |
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 $263.03 Median $371.54 Typical High $645.65 | Professional | None | $263.03 | $371.54 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $380.19 | Professional | None | $257.04 | $269.15 | $380.19 |
5 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 $131.83 Median $131.83 Typical High $144.54 | Professional | 52 · Reduced service | $131.83 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $58.88 | Professional | 53 · Discontinued | $53.70 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | 54 · Surgery only | $199.53 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $28.84 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $28.84 |
Where Washington sits
The same service costs 40.6 times more in Maine than in Montana. 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 $27,217MT $670
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.