How much rates vary
Facilitymedian $1,820 · 10th to 90th $501 to $10,471Professionalmedian $178 · 10th to 90th $22 to $1,259
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 $912.01 Median $3,715.35 Typical High $9,120.11 | Facility | None | $912.01 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,096.48 | Professional | None | $758.58 | $831.76 | $1,096.48 |
BCBS Texas Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $2,454.71 | Professional | None | $851.14 | $1,148.15 | $2,454.71 |
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 $933.25 Median $1,071.52 Typical High $1,513.56 | Professional | None | $933.25 | $1,071.52 | $1,513.56 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $8,317.64 | Professional | None | $7,413.10 | $7,413.10 | $8,317.64 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $1,905.46 Typical High $6,918.31 | Facility | None | $831.76 | $1,905.46 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,348.96 | Professional | None | $758.58 | $831.76 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $134.90 Typical High $851.14 | Professional | None | $19.95 | $134.90 | $851.14 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,348.96 Typical High $251,188.64 | Facility | None | $758.58 | $1,348.96 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,513.56 | Professional | None | $933.25 | $1,071.52 | $1,513.56 |
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 $707.95 Median $954.99 Typical High $1,479.11 | Professional | None | $707.95 | $954.99 | $1,479.11 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $380.19 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $416.87 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $165.96 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $616.60 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $660.69 |
Where Texas 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 $16,050AR $1,584
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.