How much rates vary
Facilitymedian $1,000 · 10th to 90th $589 to $2,692Professionalmedian $1,549 · 10th to 90th $158 to $2,884
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 $1,698.24 Median $4,677.35 Typical High $21,877.62 | Facility | None | $1,698.24 | $4,677.35 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,698.24 | $2,818.38 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $2,187.76 | Professional | None | $302.00 | $302.00 | $2,187.76 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $891.25 Typical High $8,128.31 | Facility | None | $30.20 | $891.25 | $8,128.31 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1,819.70 Median $3,388.44 Typical High $11,481.54 | Professional | None | $1,819.70 | $3,388.44 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $891.25 Typical High $2,691.53 | Facility | None | $707.95 | $891.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $3,801.89 | Professional | None | $1,621.81 | $1,778.28 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,691.53 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $1,412.54 Typical High $2,818.38 | Professional | None | $154.88 | $1,412.54 | $2,818.38 |
Pacific Source Setting Facility Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $2,630.27 | Facility | None | $2,187.76 | $2,570.40 | $2,630.27 |
Premera BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,819.70 | Facility | None | $1,778.28 | $1,778.28 | $1,819.70 |
Premera BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,819.70 Median $2,630.27 Typical High $3,548.13 | Professional | None | $1,819.70 | $2,630.27 | $3,548.13 |
United Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $1,584.89 | Facility | None | $524.81 | $758.58 | $1,584.89 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $4,073.80 | Professional | None | $1,659.59 | $2,290.87 | $4,073.80 |
Wellpoint Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,584.89 | $1,659.59 | $2,398.83 |
6 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 $851.14 Typical High $870.96 | Professional | 52 · Reduced service | $851.14 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | 53 · Discontinued | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,202.26 |
Where Washington sits
The same service costs 14.0 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 $28,122MD $2,008
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.