How much rates vary
Facilitymedian $2,089 · 10th to 90th $851 to $8,710Professionalmedian $501 · 10th to 90th $33 to $891
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 $870.96 Median $3,715.35 Typical High $9,120.11 | Facility | None | $870.96 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,023.29 | Professional | None | $741.31 | $776.25 | $1,023.29 |
BCBS Texas Setting Facility Modifier None Typical Low $812.83 Median $1,513.56 Typical High $8,128.31 | Facility | None | $812.83 | $1,513.56 | $8,128.31 |
BCBS Texas Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,230.27 | Professional | None | $691.83 | $891.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,691.53 | Facility | None | $630.96 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,348.96 | Professional | None | $794.33 | $891.25 | $1,348.96 |
Lucent Health Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Professional | None | $9,772.37 | $9,772.37 | $9,772.37 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $1,819.70 Typical High $6,918.31 | Facility | None | $707.95 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,023.29 | Professional | None | $741.31 | $776.25 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $114.82 Typical High $676.08 | Professional | None | $25.12 | $114.82 | $676.08 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $251,188.64 | Facility | None | $691.83 | $1,348.96 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,348.96 | Professional | None | $794.33 | $891.25 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,288.25 | Professional | None | $616.60 | $831.76 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $380.19 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $114.82 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $537.03 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $380.19 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $380.19 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $151.36 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $575.44 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $114.82 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $114.82 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $537.03 | $630.96 |
Where Texas sits
The same service costs 7.8 times more in Maine than in Massachusetts. 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 $16,585MA $2,122
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.