How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,072 to $7,943Professionalmedian $2,818 · 10th to 90th $1,413 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 $1,445.44 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,445.44 | $2,344.23 | $2,344.23 |
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 $1,905.46 Median $2,570.40 Typical High $4,265.80 | Professional | None | $1,905.46 | $2,570.40 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,801.89 | Professional | None | $2,454.71 | $3,090.30 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $2,344.23 Median $3,801.89 Typical High $7,943.28 | Facility | None | $2,344.23 | $3,801.89 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,621.81 | $2,344.23 | $3,548.13 |
Pacific Source Setting Facility Modifier None Typical Low $1,862.09 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,862.09 | $3,019.95 | $3,235.94 |
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 $2,884.03 Typical High $4,677.35 | Professional | None | $79.43 | $2,884.03 | $4,677.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | None | $8,128.31 | $8,128.31 | $8,128.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,019.95 Median $3,235.94 Typical High $4,168.69 | Professional | None | $3,019.95 | $3,235.94 | $4,168.69 |
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 $2,344.23 Median $2,951.21 Typical High $4,897.79 | Professional | None | $2,344.23 | $2,951.21 | $4,897.79 |
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 $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $851.14 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $346.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,288.25 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $257.04 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $173.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,071.52 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $426.58 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,621.81 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $323.59 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $213.80 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,659.59 | $1,659.59 |
Where Oregon sits
The same service costs 8.1 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 $2,222
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.