How much rates vary
Facilitymedian $1,549 · 10th to 90th $871 to $7,943Professionalmedian $1,479 · 10th to 90th $759 to $2,239
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 $851.14 Median $1,230.27 Typical High $1,230.27 | Professional | None | $851.14 | $1,230.27 | $1,230.27 |
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 $977.24 Median $1,348.96 Typical High $2,238.72 | Professional | None | $977.24 | $1,348.96 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,659.59 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $7,943.28 | Facility | None | $1,230.27 | $1,949.84 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,258.93 | $1,949.84 |
Pacific Source Setting Facility Modifier None Typical Low $954.99 Median $1,513.56 Typical High $1,659.59 | Facility | None | $954.99 | $1,513.56 | $1,659.59 |
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 $1,479.11 Typical High $2,454.71 | Professional | None | $79.43 | $1,479.11 | $2,454.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Facility | None | $4,168.69 | $4,168.69 | $4,168.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,659.59 | $2,137.96 |
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 $1,202.26 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,513.56 | $2,511.89 |
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 $446.68 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $446.68 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $177.83 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $660.69 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $131.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $89.13 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $616.60 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $562.34 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $223.87 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $831.76 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $169.82 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $112.20 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $776.25 | $851.14 | $851.14 |
Where Oregon sits
The same service costs 11.8 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 $16,920MD $1,433
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.