How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,549 to $7,943Professionalmedian $3,548 · 10th to 90th $1,862 to $5,370
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 $1,862.09 Median $2,398.83 Typical High $2,951.21 | Professional | None | $1,862.09 | $2,398.83 | $2,951.21 |
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 $2,511.89 Median $3,235.94 Typical High $5,011.87 | Professional | None | $2,511.89 | $3,235.94 | $5,011.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,311.31 Median $3,801.89 Typical High $4,570.88 | Professional | None | $3,311.31 | $3,801.89 | $4,570.88 |
Moda Health Setting Facility Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $38,018.94 | Facility | None | $2,511.89 | $4,365.16 | $38,018.94 |
Moda Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $5,011.87 | Professional | None | $2,398.83 | $2,951.21 | $5,011.87 |
Pacific Source Setting Facility Modifier None Typical Low $2,187.76 Median $3,548.13 Typical High $3,801.89 | Facility | None | $2,187.76 | $3,548.13 | $3,801.89 |
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 $3,467.37 Typical High $5,495.41 | Professional | None | $79.43 | $3,467.37 | $5,495.41 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Facility | None | $9,772.37 | $9,772.37 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,630.78 Median $3,801.89 Typical High $5,754.40 | Professional | None | $3,630.78 | $3,801.89 | $5,754.40 |
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 $2,754.23 Median $3,981.07 Typical High $6,606.93 | Professional | None | $2,754.23 | $3,981.07 | $6,606.93 |
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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $478.63 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,698.24 |
Where Oregon sits
The same service costs 13.4 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 $34,930MD $2,604
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.