How much rates vary
Facilitymedian $1,023 · 10th to 90th $589 to $4,266Professionalmedian $2,291 · 10th to 90th $269 to $4,365
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 $2,951.21 Median $7,943.28 Typical High $27,542.29 | Facility | None | $2,951.21 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,238.72 | $2,951.21 | $2,951.21 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $1,513.56 Typical High $13,182.57 | Facility | None | $30.20 | $1,513.56 | $13,182.57 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $3,467.37 Median $15,135.61 Typical High $17,782.79 | Professional | None | $3,467.37 | $15,135.61 | $17,782.79 |
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 $2,238.72 Median $2,570.40 Typical High $5,370.32 | Professional | None | $2,238.72 | $2,570.40 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $3,235.94 Typical High $5,370.32 | Professional | None | $1,949.84 | $3,235.94 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $2,089.30 Typical High $4,265.80 | Professional | None | $257.04 | $2,089.30 | $4,265.80 |
Pacific Source Setting Facility Modifier None Typical Low $2,511.89 Median $4,073.80 Typical High $4,365.16 | Facility | None | $2,511.89 | $4,073.80 | $4,365.16 |
Premera BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,951.21 | Facility | None | $2,884.03 | $2,884.03 | $2,951.21 |
Premera BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,897.79 | Professional | None | $3,467.37 | $3,467.37 | $4,897.79 |
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 $2,398.83 Median $3,090.30 Typical High $5,623.41 | Professional | None | $2,398.83 | $3,090.30 | $5,623.41 |
Wellpoint Setting Professional Modifier None Typical Low $1,995.26 Median $2,691.53 Typical High $4,073.80 | Professional | None | $1,995.26 | $2,691.53 | $4,073.80 |
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 $1,122.02 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,122.02 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $446.68 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,698.24 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $338.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $223.87 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,041.74 | $2,041.74 |
Where Washington sits
The same service costs 6.7 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 $18,667MD $2,801
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.