How much rates vary
Facilitymedian $1,905 · 10th to 90th $955 to $7,943Professionalmedian $1,820 · 10th to 90th $955 to $2,692
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 $1,174.90 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,479.11 | $1,479.11 |
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 $1,202.26 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,621.81 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,584.89 | $1,995.26 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $7,943.28 | Facility | None | $1,479.11 | $2,344.23 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,548.82 | $2,344.23 |
Pacific Source Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $1,995.26 | Facility | None | $1,174.90 | $1,862.09 | $1,995.26 |
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 $1,819.70 Typical High $2,951.21 | Professional | None | $79.43 | $1,819.70 | $2,951.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,041.74 | $2,630.27 |
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 $1,445.44 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,819.70 | $3,090.30 |
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 $549.54 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $549.54 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $218.78 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $812.83 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $162.18 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $109.65 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $758.58 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $676.08 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $275.42 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,047.13 |
Where Oregon sits
The same service costs 10.6 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 $17,137MD $1,609
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.