How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,000 to $251,189Professionalmedian $3,890 · 10th to 90th $1,096 to $5,888
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $5,888.44 Median $12,022.64 Typical High $16,595.87 | Facility | None | $5,888.44 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $5,888.44 Typical High $5,888.44 | Professional | None | $1,071.52 | $5,888.44 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,548.82 Typical High $3,311.31 | Professional | None | $933.25 | $1,548.82 | $3,311.31 |
Moda Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,888.44 Typical High $8,317.64 | Facility | None | $1,737.80 | $5,888.44 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $6,606.93 | Professional | None | $1,202.26 | $4,570.88 | $6,606.93 |
Premera BCBS Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Providence Setting Facility Modifier None Typical Low $5,888.44 Median $251,188.64 Typical High $346,736.85 | Facility | None | $5,888.44 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,584.89 Typical High $3,311.31 | Professional | None | $60.26 | $1,584.89 | $3,311.31 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,071.52 Typical High $4,265.80 | Facility | None | $691.83 | $1,071.52 | $4,265.80 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $2,951.21 Typical High $6,760.83 | Professional | None | $1,047.13 | $2,951.21 | $6,760.83 |
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 $537.03 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $537.03 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $218.78 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $812.83 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $162.18 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $107.15 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $758.58 | $4,073.80 | $4,073.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $602.56 | $2,951.21 | $2,951.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $239.88 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $891.25 | $4,365.16 | $4,365.16 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $177.83 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $120.23 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $831.76 | $4,073.80 | $4,073.80 |
Where Alaska sits
The same service costs 10.0 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 $17,294MD $1,737
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.