How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,622 to $15,849Professionalmedian $2,455 · 10th to 90th $1,230 to $3,715
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,258.93 | $2,041.74 | $2,041.74 |
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 $1,659.59 Median $2,187.76 Typical High $3,715.35 | Professional | None | $1,659.59 | $2,187.76 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,137.96 | $2,691.53 | $3,311.31 |
Moda Health Setting Facility Modifier None Typical Low $2,238.72 Median $7,943.28 Typical High $24,547.09 | Facility | None | $2,238.72 | $7,943.28 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,412.54 | $2,089.30 | $3,388.44 |
Pacific Source Setting Facility Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $2,754.23 | Facility | None | $1,621.81 | $2,630.27 | $2,754.23 |
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 $2,511.89 Typical High $4,073.80 | Professional | None | $79.43 | $2,511.89 | $4,073.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Facility | None | $7,079.46 | $7,079.46 | $7,079.46 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $3,630.78 | Professional | None | $2,630.27 | $2,754.23 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,467.37 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,467.37 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $4,265.80 | Professional | None | $1,995.26 | $2,570.40 | $4,265.80 |
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 $741.31 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $741.31 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $302.00 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,122.02 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $223.87 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $151.36 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $933.25 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $371.54 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,412.54 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $281.84 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $186.21 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,445.44 | $1,445.44 |
Where Oregon sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.