How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,380 to $7,943Professionalmedian $3,631 · 10th to 90th $1,950 to $5,623
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 $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
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 $2,630.27 Median $3,388.44 Typical High $5,248.07 | Professional | None | $2,630.27 | $3,388.44 | $5,248.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $4,365.16 | Professional | None | $3,162.28 | $3,715.35 | $4,365.16 |
Moda Health Setting Facility Modifier None Typical Low $2,754.23 Median $4,677.35 Typical High $7,943.28 | Facility | None | $2,754.23 | $4,677.35 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $5,011.87 | Professional | None | $2,511.89 | $2,951.21 | $5,011.87 |
Pacific Source Setting Facility Modifier None Typical Low $2,238.72 Median $3,715.35 Typical High $3,801.89 | Facility | None | $2,238.72 | $3,715.35 | $3,801.89 |
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 $3,548.13 Typical High $5,623.41 | Professional | None | $79.43 | $3,548.13 | $5,623.41 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Facility | None | $9,772.37 | $9,772.37 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,630.78 Median $3,801.89 Typical High $5,754.40 | Professional | None | $3,630.78 | $3,801.89 | $5,754.40 |
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 $2,818.38 Median $4,073.80 Typical High $6,606.93 | Professional | None | $2,818.38 | $4,073.80 | $6,606.93 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,737.80 |
Where Oregon sits
The same service costs 9.7 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 $25,600MD $2,652
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.