How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,259 to $7,943Professionalmedian $2,818 · 10th to 90th $1,479 to $4,266
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,778.28 | $2,290.87 | $2,290.87 |
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 $1,862.09 Median $2,454.71 Typical High $4,168.69 | Professional | None | $1,862.09 | $2,454.71 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,715.35 | Professional | None | $2,398.83 | $3,019.95 | $3,715.35 |
Moda Health Setting Facility Modifier None Typical Low $2,290.87 Median $3,715.35 Typical High $7,943.28 | Facility | None | $2,290.87 | $3,715.35 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,398.83 Typical High $3,630.78 | Professional | None | $2,290.87 | $2,398.83 | $3,630.78 |
Pacific Source Setting Facility Modifier None Typical Low $1,819.70 Median $2,884.03 Typical High $3,162.28 | Facility | None | $1,819.70 | $2,884.03 | $3,162.28 |
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 $2,818.38 Typical High $4,570.88 | Professional | None | $79.43 | $2,818.38 | $4,570.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,951.21 Median $3,162.28 Typical High $4,073.80 | Professional | None | $2,951.21 | $3,162.28 | $4,073.80 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $4,786.30 | Professional | None | $2,290.87 | $2,884.03 | $4,786.30 |
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 $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $851.14 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $338.84 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,258.93 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $251.19 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $169.82 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,047.13 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $426.58 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,584.89 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $316.23 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $208.93 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,621.81 | $1,621.81 |
Where Oregon sits
The same service costs 8.2 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 $17,891MD $2,184
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.