How much rates vary
Facilitymedian $1,514 · 10th to 90th $661 to $6,026Professionalmedian $204 · 10th to 90th $22 to $1,413
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 $1,122.02 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,318.26 | $1,659.59 |
BCBS Setting Facility Modifier None Typical Low $851.14 Median $1,380.38 Typical High $2,884.03 | Facility | None | $851.14 | $1,380.38 | $2,884.03 |
BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,479.11 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $2,691.53 | Facility | None | $630.96 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,513.56 | $1,819.70 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $10,715.19 | Professional | None | $8,912.51 | $8,912.51 | $10,715.19 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $1,905.46 Typical High $6,025.60 | Facility | None | $977.24 | $1,905.46 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,318.26 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $169.82 Typical High $1,148.15 | Professional | None | $19.95 | $169.82 | $1,148.15 |
Oscar Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,071.52 | Professional | None | $1,023.29 | $1,023.29 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $1,584.89 Typical High $251,188.64 | Facility | None | $851.14 | $1,584.89 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,513.56 | $1,819.70 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,862.09 | Professional | None | $977.24 | $1,258.93 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
13 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 $602.56 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $602.56 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $1,122.02 | Professional | 54 · Surgery only | $912.01 | $977.24 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $223.87 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $131.83 Typical High $147.91 | Professional | 56 · Pre-op care only | $120.23 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $1,047.13 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | XS · Separate structure | $588.84 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $660.69 Typical High $691.83 | Professional | 52 · Reduced service | $602.56 | $660.69 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $263.03 Typical High $275.42 | Professional | 53 · Discontinued | $239.88 | $263.03 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $977.24 | $1,047.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $208.93 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $131.83 Typical High $138.04 | Professional | 56 · Pre-op care only | $120.23 | $131.83 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $977.24 |
Where Texas sits
The same service costs 8.1 times more in Maine than in Texas. 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 $13,962TX $1,718
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.