How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,148 to $5,495Professionalmedian $3,162 · 10th to 90th $1,622 to $4,786
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 $2,630.27 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,630.27 | $2,630.27 |
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 $2,089.30 Median $2,818.38 Typical High $4,677.35 | Professional | None | $2,089.30 | $2,818.38 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $4,168.69 | Professional | None | $2,691.53 | $3,388.44 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $2,630.27 Median $4,168.69 Typical High $7,943.28 | Facility | None | $2,630.27 | $4,168.69 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $4,073.80 | Professional | None | $2,089.30 | $2,630.27 | $4,073.80 |
Pacific Source Setting Facility Modifier None Typical Low $2,041.74 Median $3,388.44 Typical High $3,548.13 | Facility | None | $2,041.74 | $3,388.44 | $3,548.13 |
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 $3,162.28 Typical High $5,128.61 | Professional | None | $79.43 | $3,162.28 | $5,128.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,388.44 Median $3,548.13 Typical High $4,570.88 | Professional | None | $3,388.44 | $3,548.13 | $4,570.88 |
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 $2,570.40 Median $3,235.94 Typical High $5,495.41 | Professional | None | $2,570.40 | $3,235.94 | $5,495.41 |
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 $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $954.99 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $380.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,412.54 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $288.40 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $190.55 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,202.26 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $478.63 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,778.28 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $354.81 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $239.88 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,819.70 | $1,819.70 |
Where Oregon sits
The same service costs 7.6 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 $18,140MD $2,382
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.