How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,000 to $251,189Professionalmedian $2,692 · 10th to 90th $759 to $4,074
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 $4,073.80 Median $12,022.64 Typical High $16,595.87 | Facility | None | $4,073.80 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $4,073.80 Typical High $4,073.80 | Professional | None | $741.31 | $4,073.80 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $2,290.87 | Professional | None | $676.08 | $1,071.52 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,202.26 | $4,073.80 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $3,162.28 Typical High $4,570.88 | Professional | None | $831.76 | $3,162.28 | $4,570.88 |
Premera BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Providence Setting Facility Modifier None Typical Low $4,073.80 Median $251,188.64 Typical High $346,736.85 | Facility | None | $4,073.80 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,096.48 Typical High $2,290.87 | Professional | None | $60.26 | $1,096.48 | $2,290.87 |
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 $724.44 Median $2,041.74 Typical High $4,570.88 | Professional | None | $724.44 | $2,041.74 | $4,570.88 |
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 $371.54 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $371.54 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $147.91 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $549.54 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $109.65 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $74.13 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $512.86 | $2,818.38 | $2,818.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $416.87 | $1,995.26 | $1,995.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $165.96 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $616.60 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $123.03 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $83.18 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $575.44 | $2,818.38 | $2,818.38 |
Where Alaska sits
The same service costs 12.3 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 $16,849MD $1,375
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.