How much rates vary
Facilitymedian $708 · 10th to 90th $234 to $2,138Professionalmedian $224 · 10th to 90th $138 to $407
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 $186.21 Median $7,943.28 Typical High $27,542.29 | Facility | None | $186.21 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $208.93 | Professional | None | $147.91 | $186.21 | $208.93 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $95.50 Typical High $870.96 | Facility | None | $30.20 | $95.50 | $870.96 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $2,691.53 | Professional | None | $223.87 | $354.81 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $776.25 Typical High $2,137.96 | Facility | None | $707.95 | $776.25 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $169.82 Typical High $354.81 | Professional | None | $165.96 | $169.82 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $346.74 | Professional | None | $128.82 | $213.80 | $346.74 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $407.38 | Professional | None | $125.89 | $234.42 | $407.38 |
Pacific Source Setting Facility Modifier None Typical Low $204.17 Median $263.03 Typical High $281.84 | Facility | None | $204.17 | $263.03 | $281.84 |
Premera BCBS Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Premera BCBS Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $323.59 | Professional | None | $223.87 | $223.87 | $323.59 |
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 $165.96 Median $204.17 Typical High $371.54 | Professional | None | $165.96 | $204.17 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $251.19 | Professional | None | $123.03 | $165.96 | $251.19 |
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 $74.13 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $74.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $29.51 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $109.65 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $21.88 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.79 | $18.62 | $18.62 |
Where Washington sits
The same service costs 36.6 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 $16,031MT $438
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.