How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,259 to $10,233Professionalmedian $2,512 · 10th to 90th $1,318 to $3,890
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,737.80 | $1,862.09 |
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 $1,819.70 Median $2,344.23 Typical High $3,630.78 | Professional | None | $1,819.70 | $2,344.23 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $3,090.30 | Professional | None | $2,187.76 | $2,570.40 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $2,089.30 Median $3,630.78 Typical High $24,547.09 | Facility | None | $2,089.30 | $3,630.78 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,445.44 | $1,949.84 | $3,548.13 |
Pacific Source Setting Facility Modifier None Typical Low $1,548.82 Median $2,570.40 Typical High $2,691.53 | Facility | None | $1,548.82 | $2,570.40 | $2,691.53 |
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 $2,511.89 Typical High $3,890.45 | Professional | None | $79.43 | $2,511.89 | $3,890.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,918.31 | $6,918.31 | $6,918.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,511.89 Median $2,691.53 Typical High $3,981.07 | Professional | None | $2,511.89 | $2,691.53 | $3,981.07 |
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 $1,995.26 Median $2,818.38 Typical High $4,570.88 | Professional | None | $1,995.26 | $2,818.38 | $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 $870.96 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $870.96 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Where Oregon sits
The same service costs 13.9 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 $28,165MD $2,021
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.