How much rates vary
Facilitymedian $2,188 · 10th to 90th $891 to $13,183Professionalmedian $251 · 10th to 90th $28 to $1,738
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 $1,148.15 Median $3,890.45 Typical High $10,964.78 | Facility | None | $1,148.15 | $3,890.45 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,584.89 | $1,698.24 | $1,949.84 |
BCBS Texas Setting Facility Modifier None Typical Low $1,202.26 Median $2,187.76 Typical High $11,481.54 | Facility | None | $1,202.26 | $2,187.76 | $11,481.54 |
BCBS Texas Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,905.46 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $15,488.17 | Facility | None | $660.69 | $1,318.26 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,949.84 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $13,803.84 Median $13,803.84 Typical High $13,803.84 | Professional | None | $13,803.84 | $13,803.84 | $13,803.84 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $7,943.28 | Facility | None | $1,000.00 | $2,570.40 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,698.24 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $218.78 Typical High $1,445.44 | Professional | None | $26.30 | $218.78 | $1,445.44 |
Oscar Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,479.11 | $1,479.11 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $1,995.26 Typical High $251,188.64 | Facility | None | $851.14 | $1,995.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,380.38 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,995.26 | $2,398.83 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $11,220.18 | Facility | None | $407.38 | $2,137.96 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,659.59 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $776.25 Median $851.14 Typical High $977.24 | Professional | 52 · Reduced service | $776.25 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $338.84 Typical High $389.05 | Professional | 53 · Discontinued | $316.23 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,258.93 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,174.90 | $1,258.93 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $169.82 Typical High $194.98 | Professional | 56 · Pre-op care only | $158.49 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,174.90 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,174.90 | $1,348.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $851.14 Typical High $891.25 | Professional | 52 · Reduced service | $776.25 | $851.14 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $338.84 Typical High $354.81 | Professional | 53 · Discontinued | $316.23 | $338.84 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,258.93 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,174.90 | $1,258.93 | $1,348.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $257.04 Typical High $269.15 | Professional | 55 · Aftercare only | $234.42 | $257.04 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $169.82 Typical High $177.83 | Professional | 56 · Pre-op care only | $158.49 | $169.82 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,174.90 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,174.90 | $1,258.93 |
Where Texas 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.