How much rates vary
Facilitymedian $1,905 · 10th to 90th $501 to $10,471Professionalmedian $224 · 10th to 90th $28 to $1,660
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 $1,071.52 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,071.52 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,148.15 | $1,513.56 |
BCBS Texas Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,691.53 | Professional | None | $1,174.90 | $1,412.54 | $2,691.53 |
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 $1,288.25 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,479.11 | $2,137.96 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $10,964.78 | Professional | None | $8,709.64 | $8,709.64 | $10,964.78 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,949.84 Typical High $6,025.60 | Facility | None | $1,000.00 | $1,949.84 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,148.15 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $177.83 Typical High $1,148.15 | Professional | None | $25.70 | $177.83 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,513.56 Typical High $251,188.64 | Facility | None | $812.83 | $1,513.56 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,479.11 | $2,137.96 |
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 $977.24 Median $1,318.26 Typical High $2,041.74 | Professional | None | $977.24 | $1,318.26 | $2,041.74 |
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 $512.86 Median $562.34 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $257.04 | Professional | 53 · Discontinued | $204.17 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $977.24 | Professional | 54 · Surgery only | $758.58 | $831.76 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $912.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $562.34 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $562.34 | $645.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $257.04 | Professional | 53 · Discontinued | $204.17 | $223.87 | $257.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $977.24 | Professional | 54 · Surgery only | $758.58 | $831.76 | $977.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $128.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $912.01 |
Where Texas 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.