How much rates vary
Facilitymedian $2,455 · 10th to 90th $603 to $10,471Professionalmedian $1,000 · 10th to 90th $85 to $2,455
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 $1,122.02 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,445.44 | $1,949.84 |
BCBS Texas Setting Facility Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $9,772.37 | Facility | None | $1,548.82 | $2,884.03 | $9,772.37 |
BCBS Texas Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,778.28 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $2,691.53 | Facility | None | $630.96 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,698.24 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $16,595.87 Median $17,782.79 Typical High $17,782.79 | Professional | None | $16,595.87 | $17,782.79 | $17,782.79 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,187.76 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,445.44 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $223.87 Typical High $1,258.93 | Professional | None | $79.43 | $223.87 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,949.84 Typical High $251,188.64 | Facility | None | $812.83 | $1,949.84 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,698.24 | $2,570.40 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,584.89 | $2,454.71 |
Wellpoint Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $707.95 Median $724.44 Typical High $851.14 | Professional | 52 · Reduced service | $707.95 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,096.48 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,071.52 | $1,096.48 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $218.78 Typical High $257.04 | Professional | 55 · Aftercare only | $213.80 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $144.54 Typical High $169.82 | Professional | 56 · Pre-op care only | $141.25 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,023.29 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,023.29 | $1,202.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $724.44 Typical High $851.14 | Professional | 52 · Reduced service | $707.95 | $724.44 | $851.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $288.40 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,096.48 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,071.52 | $1,096.48 | $1,288.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $218.78 Typical High $257.04 | Professional | 55 · Aftercare only | $213.80 | $218.78 | $257.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $144.54 Typical High $169.82 | Professional | 56 · Pre-op care only | $141.25 | $144.54 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,023.29 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,023.29 | $1,202.26 |
Where Texas sits
The same service costs 11.6 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 $24,998MD $2,147
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.