How much rates vary
Facilitymedian $1,023 · 10th to 90th $589 to $3,802Professionalmedian $1,995 · 10th to 90th $219 to $3,890
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 $2,570.40 Median $7,943.28 Typical High $27,542.29 | Facility | None | $2,570.40 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,570.40 | $2,691.53 |
Ambetter Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $1,318.26 Typical High $11,748.98 | Facility | None | $30.20 | $1,318.26 | $11,748.98 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $3,090.30 Median $13,489.63 Typical High $15,488.17 | Professional | None | $3,090.30 | $13,489.63 | $15,488.17 |
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 $2,290.87 Typical High $4,786.30 | Professional | None | $1,995.26 | $2,290.87 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,884.03 Typical High $4,677.35 | Professional | None | $1,737.80 | $2,884.03 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $1,819.70 Typical High $3,715.35 | Professional | None | $208.93 | $1,819.70 | $3,715.35 |
Pacific Source Setting Facility Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $3,890.45 | Facility | None | $2,691.53 | $3,467.37 | $3,890.45 |
Premera BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,630.27 | Facility | None | $2,570.40 | $2,570.40 | $2,630.27 |
Premera BCBS Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $4,466.84 | Professional | None | $3,090.30 | $3,090.30 | $4,466.84 |
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 $2,137.96 Median $2,754.23 Typical High $5,011.87 | Professional | None | $2,137.96 | $2,754.23 | $5,011.87 |
Wellpoint Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,737.80 | $2,344.23 | $3,548.13 |
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 $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,023.29 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $407.38 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,513.56 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $302.00 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $204.17 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,819.70 | $1,819.70 |
Where Washington sits
The same service costs 7.2 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 $18,361MD $2,558
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.