How much rates vary
Facilitymedian $1,023 · 10th to 90th $589 to $3,981Professionalmedian $1,622 · 10th to 90th $186 to $3,890
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 $2,754.23 Median $7,943.28 Typical High $27,542.29 | Facility | None | $2,754.23 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,089.30 | $2,754.23 | $2,754.23 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $1,412.54 Typical High $12,589.25 | Facility | None | $30.20 | $1,412.54 | $12,589.25 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $3,162.28 Median $14,454.40 Typical High $16,218.10 | Professional | None | $3,162.28 | $14,454.40 | $16,218.10 |
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 $2,137.96 Median $2,454.71 Typical High $5,011.87 | Professional | None | $2,137.96 | $2,454.71 | $5,011.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $3,090.30 Typical High $5,128.61 | Professional | None | $1,862.09 | $3,090.30 | $5,128.61 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $1,479.11 Typical High $3,715.35 | Professional | None | $181.97 | $1,479.11 | $3,715.35 |
Pacific Source Setting Facility Modifier None Typical Low $2,951.21 Median $3,715.35 Typical High $4,073.80 | Facility | None | $2,951.21 | $3,715.35 | $4,073.80 |
Premera BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,754.23 | Facility | None | $2,691.53 | $2,691.53 | $2,754.23 |
Premera BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $4,570.88 | Professional | None | $3,162.28 | $3,162.28 | $4,570.88 |
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 $2,344.23 Median $2,884.03 Typical High $5,248.07 | Professional | None | $2,344.23 | $2,884.03 | $5,248.07 |
Wellpoint Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,511.89 | $3,801.89 |
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 $1,071.52 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,071.52 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $426.58 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,584.89 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $316.23 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $213.80 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,949.84 | $1,949.84 |
Where Washington sits
The same service costs 10.9 times more in Maine than in Washington. 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 $28,933WA $2,645
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.