How much rates vary
Facilitymedian $1,905 · 10th to 90th $708 to $5,370Professionalmedian $1,047 · 10th to 90th $155 to $2,188
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 $1,148.15 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,148.15 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $660.69 Typical High $6,309.57 | Facility | None | $30.20 | $660.69 | $6,309.57 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1,348.96 Median $7,079.46 Typical High $7,585.78 | Professional | None | $1,348.96 | $7,079.46 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $776.25 Typical High $2,137.96 | Facility | None | $707.95 | $776.25 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,258.93 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,995.26 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $977.24 Typical High $2,089.30 | Professional | None | $151.36 | $977.24 | $2,089.30 |
Pacific Source Setting Facility Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $1,995.26 | Facility | None | $1,445.44 | $1,819.70 | $1,995.26 |
Premera BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,380.38 | Facility | None | $1,348.96 | $1,348.96 | $1,380.38 |
Premera BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $12,022.64 | Facility | None | $12,022.64 | $12,022.64 | $12,022.64 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,949.84 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $4,897.79 | Facility | None | $1,479.11 | $2,398.83 | $4,897.79 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,698.24 | $3,090.30 |
Wellpoint Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,230.27 | $1,778.28 |
6 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 $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Where Washington sits
The same service costs 10.1 times more in Maine than in Arkansas. 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 $23,736AR $2,352
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.