How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,047 to $7,943Professionalmedian $2,344 · 10th to 90th $1,096 to $3,631
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 $1,096.48 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,621.81 | $1,621.81 |
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 $1,698.24 Median $2,187.76 Typical High $3,311.31 | Professional | None | $1,698.24 | $2,187.76 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $3,090.30 | Professional | None | $2,238.72 | $2,570.40 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $1,698.24 Median $2,951.21 Typical High $7,943.28 | Facility | None | $1,698.24 | $2,951.21 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,348.96 | $2,041.74 | $3,311.31 |
Pacific Source Setting Facility Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $2,511.89 | Facility | None | $1,445.44 | $2,187.76 | $2,511.89 |
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 $2,344.23 Typical High $3,715.35 | Professional | None | $79.43 | $2,344.23 | $3,715.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Facility | None | $6,456.54 | $6,456.54 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $3,801.89 | Professional | None | $2,398.83 | $2,511.89 | $3,801.89 |
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 $1,819.70 Median $2,691.53 Typical High $4,365.16 | Professional | None | $1,819.70 | $2,691.53 | $4,365.16 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $323.59 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Where Oregon sits
The same service costs 8.5 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 $16,489MD $1,943
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.