How much rates vary
Facilitymedian $1,023 · 10th to 90th $589 to $3,548Professionalmedian $1,820 · 10th to 90th $219 to $3,548
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 $2,398.83 Median $7,943.28 Typical High $27,542.29 | Facility | None | $2,398.83 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $2,630.27 | Professional | None | $1,737.80 | $2,398.83 | $2,630.27 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $1,230.27 Typical High $10,964.78 | Facility | None | $30.20 | $1,230.27 | $10,964.78 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $2,818.38 Median $12,302.69 Typical High $14,125.38 | Professional | None | $2,818.38 | $12,302.69 | $14,125.38 |
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 $1,819.70 Median $2,089.30 Typical High $4,265.80 | Professional | None | $1,819.70 | $2,089.30 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $2,691.53 Typical High $4,365.16 | Professional | None | $1,584.89 | $2,691.53 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $1,698.24 Typical High $3,388.44 | Professional | None | $208.93 | $1,698.24 | $3,388.44 |
Pacific Source Setting Facility Modifier None Typical Low $1,995.26 Median $3,388.44 Typical High $3,548.13 | Facility | None | $1,995.26 | $3,388.44 | $3,548.13 |
Premera BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Premera BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,981.07 | Professional | None | $2,818.38 | $2,818.38 | $3,981.07 |
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 $1,949.84 Median $2,511.89 Typical High $4,570.88 | Professional | None | $1,949.84 | $2,511.89 | $4,570.88 |
Wellpoint Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $3,311.31 | Professional | None | $1,621.81 | $2,187.76 | $3,311.31 |
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 $933.25 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $933.25 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $371.54 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,412.54 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $281.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $186.21 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,659.59 | $1,659.59 |
Where Washington 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.