How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,202 to $7,943Professionalmedian $2,951 · 10th to 90th $1,549 to $4,467
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 $1,778.28 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,778.28 | $2,454.71 | $2,454.71 |
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 $1,949.84 Median $2,630.27 Typical High $4,365.16 | Professional | None | $1,949.84 | $2,630.27 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $3,890.45 | Professional | None | $2,570.40 | $3,235.94 | $3,890.45 |
Moda Health Setting Facility Modifier None Typical Low $2,454.71 Median $3,801.89 Typical High $7,943.28 | Facility | None | $2,454.71 | $3,801.89 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,454.71 | $2,570.40 | $3,890.45 |
Pacific Source Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $3,311.31 | Facility | None | $1,905.46 | $3,019.95 | $3,311.31 |
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 $2,951.21 Typical High $4,897.79 | Professional | None | $79.43 | $2,951.21 | $4,897.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Facility | None | $8,317.64 | $8,317.64 | $8,317.64 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,162.28 Median $3,311.31 Typical High $4,365.16 | Professional | None | $3,162.28 | $3,311.31 | $4,365.16 |
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 $2,398.83 Median $3,019.95 Typical High $5,011.87 | Professional | None | $2,398.83 | $3,019.95 | $5,011.87 |
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 $891.25 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $891.25 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $354.81 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,348.96 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $269.15 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $177.83 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,122.02 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $446.68 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,659.59 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $338.84 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $223.87 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,698.24 | $1,698.24 |
Where Oregon sits
The same service costs 7.8 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 $17,987MD $2,300
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.