How much rates vary
Facilitymedian $2,399 · 10th to 90th $490 to $10,471Professionalmedian $1,585 · 10th to 90th $63 to $4,467
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 $1,122.02 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,570.40 | $2,884.03 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $5,754.40 | Professional | None | $2,884.03 | $3,715.35 | $5,754.40 |
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 $3,235.94 Median $3,801.89 Typical High $5,370.32 | Professional | None | $3,235.94 | $3,801.89 | $5,370.32 |
Lucent Health Setting Professional Modifier None Typical Low $21,877.62 Median $21,877.62 Typical High $26,915.35 | Professional | None | $21,877.62 | $21,877.62 | $26,915.35 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,548.13 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,548.13 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $4,265.80 | Professional | None | $2,570.40 | $2,884.03 | $4,265.80 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $416.87 Typical High $2,754.23 | Professional | None | $58.88 | $416.87 | $2,754.23 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,691.53 Typical High $251,188.64 | Facility | None | $812.83 | $2,691.53 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $5,370.32 | Professional | None | $3,235.94 | $3,801.89 | $5,370.32 |
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 $2,511.89 Median $3,388.44 Typical High $5,248.07 | Professional | None | $2,511.89 | $3,388.44 | $5,248.07 |
Wellpoint Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
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 $1,288.25 Median $1,412.54 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,288.25 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $562.34 Typical High $660.69 | Professional | 53 · Discontinued | $512.86 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,137.96 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,949.84 | $2,137.96 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $426.58 Typical High $489.78 | Professional | 55 · Aftercare only | $389.05 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $281.84 Typical High $331.13 | Professional | 56 · Pre-op care only | $257.04 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,995.26 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,995.26 | $2,290.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $1,412.54 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,288.25 | $1,412.54 | $1,659.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $562.34 Typical High $660.69 | Professional | 53 · Discontinued | $512.86 | $562.34 | $660.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,137.96 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,949.84 | $2,137.96 | $2,454.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $426.58 Typical High $501.19 | Professional | 55 · Aftercare only | $389.05 | $426.58 | $501.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $281.84 Typical High $331.13 | Professional | 56 · Pre-op care only | $257.04 | $281.84 | $331.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,995.26 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,995.26 | $2,290.87 |
Where Texas sits
The same service costs 10.8 times more in Maine than in Washington. 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 $36,725WA $3,399
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.