How much rates vary
Facilitymedian $1,413 · 10th to 90th $851 to $7,943Professionalmedian $1,380 · 10th to 90th $724 to $2,089
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 $870.96 Median $1,148.15 Typical High $1,148.15 | Professional | None | $870.96 | $1,148.15 | $1,148.15 |
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 $891.25 Median $1,230.27 Typical High $2,089.30 | Professional | None | $891.25 | $1,230.27 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,513.56 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $7,943.28 | Facility | None | $1,148.15 | $1,737.80 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,202.26 | $1,819.70 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $1,548.82 | Facility | None | $891.25 | $1,412.54 | $1,548.82 |
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 $1,380.38 Typical High $2,290.87 | Professional | None | $79.43 | $1,380.38 | $2,290.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,479.11 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,548.82 | $2,041.74 |
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 $1,122.02 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,412.54 | $2,344.23 |
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 $416.87 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $416.87 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $165.96 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $630.96 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $83.18 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $588.84 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $524.81 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $208.93 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $776.25 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $104.71 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $724.44 | $794.33 | $794.33 |
Where Oregon 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.