How much rates vary
Facilitymedian $2,291 · 10th to 90th $977 to $9,550Professionalmedian $240 · 10th to 90th $28 to $1,585
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 $1,288.25 Median $4,265.80 Typical High $9,772.37 | Facility | None | $1,288.25 | $4,265.80 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,230.27 | $2,041.74 |
BCBS Texas Setting Facility Modifier None Typical Low $954.99 Median $1,737.80 Typical High $5,370.32 | Facility | None | $954.99 | $1,737.80 | $5,370.32 |
BCBS Texas Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,513.56 | $2,290.87 |
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 $1,348.96 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,584.89 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $12,022.64 | Professional | None | $12,022.64 | $12,022.64 | $12,022.64 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $2,951.21 Typical High $7,943.28 | Facility | None | $1,096.48 | $2,951.21 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,230.27 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $177.83 Typical High $1,122.02 | Professional | None | $25.70 | $177.83 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,584.89 Typical High $251,188.64 | Facility | None | $812.83 | $1,584.89 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,584.89 | $2,290.87 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $14,791.08 | Facility | None | $2,630.27 | $6,165.95 | $14,791.08 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,380.38 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $549.54 Median $588.84 Typical High $691.83 | Professional | 52 · Reduced service | $549.54 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $275.42 | Professional | 53 · Discontinued | $218.78 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $812.83 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $138.04 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $588.84 Typical High $691.83 | Professional | 52 · Reduced service | $549.54 | $588.84 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $275.42 | Professional | 53 · Discontinued | $218.78 | $239.88 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $812.83 | $891.25 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $138.04 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $954.99 |
Where Texas sits
The same service costs 13.5 times more in Maine than in Texas. 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 $34,179TX $2,531
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.