How much rates vary
Facilitymedian $708 · 10th to 90th $347 to $2,188Professionalmedian $295 · 10th to 90th $166 to $525
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 $288.40 Median $7,943.28 Typical High $27,542.29 | Facility | None | $288.40 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $302.00 | Professional | None | $234.42 | $288.40 | $302.00 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $141.25 Typical High $1,318.26 | Facility | None | $30.20 | $141.25 | $1,318.26 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $1,862.09 | Professional | None | $331.13 | $524.81 | $1,862.09 |
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 $257.04 Typical High $549.54 | Professional | None | $257.04 | $257.04 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $549.54 | Professional | None | $194.98 | $331.13 | $549.54 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $501.19 | Professional | None | $162.18 | $295.12 | $501.19 |
Pacific Source Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $416.87 | Facility | None | $323.59 | $407.38 | $416.87 |
Premera BCBS Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Facility | None | $281.84 | $281.84 | $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 $331.13 Median $331.13 Typical High $478.63 | Professional | None | $331.13 | $331.13 | $478.63 |
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 $245.47 Median $302.00 Typical High $549.54 | Professional | None | $245.47 | $302.00 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $389.05 | Professional | None | $190.55 | $257.04 | $389.05 |
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 $114.82 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $114.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $45.71 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $34.67 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.91 | $28.84 | $28.84 |
Where Washington sits
The same service costs 13.4 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 $8,787MT $655
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.