How much rates vary
Facilitymedian $1,023 · 10th to 90th $589 to $4,786Professionalmedian $1,862 · 10th to 90th $316 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 $3,019.95 Median $7,943.28 Typical High $27,542.29 | Facility | None | $3,019.95 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,162.28 | Professional | None | $3,019.95 | $3,019.95 | $3,162.28 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $14,791.08 | Facility | None | $1,778.28 | $1,778.28 | $14,791.08 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $3,388.44 Median $16,982.44 Typical High $21,379.62 | Professional | None | $3,388.44 | $16,982.44 | $21,379.62 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $891.25 Typical High $2,691.53 | Facility | None | $707.95 | $891.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $6,918.31 | Professional | None | $2,951.21 | $3,235.94 | $6,918.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,090.30 Median $5,011.87 Typical High $6,309.57 | Professional | None | $3,090.30 | $5,011.87 | $6,309.57 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $1,513.56 Typical High $5,128.61 | Professional | None | $302.00 | $1,513.56 | $5,128.61 |
Pacific Source Setting Facility Modifier None Typical Low $3,548.13 Median $4,677.35 Typical High $4,897.79 | Facility | None | $3,548.13 | $4,677.35 | $4,897.79 |
Premera BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,388.44 | Facility | None | $3,311.31 | $3,311.31 | $3,388.44 |
Premera BCBS Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,388.44 Median $5,011.87 Typical High $6,760.83 | Professional | None | $3,388.44 | $5,011.87 | $6,760.83 |
United Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $1,584.89 | Facility | None | $524.81 | $758.58 | $1,584.89 |
United Setting Professional Modifier None Typical Low $3,019.95 Median $4,168.69 Typical High $7,762.47 | Professional | None | $3,019.95 | $4,168.69 | $7,762.47 |
Wellpoint Setting Professional Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $4,677.35 | Professional | None | $3,090.30 | $3,235.94 | $4,677.35 |
6 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 $1,479.11 Median $1,479.11 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,479.11 | $1,479.11 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | 53 · Discontinued | $602.56 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,238.72 Typical High $2,344.23 | Professional | 54 · Surgery only | $2,238.72 | $2,238.72 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $467.74 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $2,187.76 |
Where Washington sits
The same service costs 12.4 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 $35,748WA $2,885
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.