How much rates vary
Facilitymedian $1,995 · 10th to 90th $501 to $10,471Professionalmedian $977 · 10th to 90th $85 to $2,239
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 $1,348.96 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,380.38 | $1,819.70 |
BCBS Texas Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,621.81 | $2,570.40 |
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 $1,412.54 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,584.89 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $11,481.54 Median $12,882.50 Typical High $12,882.50 | Professional | None | $11,481.54 | $12,882.50 | $12,882.50 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,089.30 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,089.30 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,380.38 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $213.80 Typical High $1,230.27 | Professional | None | $79.43 | $213.80 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,819.70 Typical High $251,188.64 | Facility | None | $812.83 | $1,819.70 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,584.89 | $2,454.71 |
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 $1,071.52 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,479.11 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $660.69 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $323.59 | Professional | 53 · Discontinued | $269.15 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,122.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $676.08 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $323.59 | Professional | 53 · Discontinued | $269.15 | $275.42 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,122.02 |
Where Texas sits
The same service costs 12.0 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 $24,859MD $2,076
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.