How much rates vary
Facilitymedian $1,047 · 10th to 90th $589 to $4,786Professionalmedian $2,692 · 10th to 90th $407 to $5,495
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 $3,162.28 Median $7,943.28 Typical High $27,542.29 | Facility | None | $3,162.28 | $7,943.28 | $27,542.29 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $3,467.37 | Professional | None | $2,290.87 | $3,162.28 | $3,467.37 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $30.20 Median $1,659.59 Typical High $15,848.93 | Facility | None | $30.20 | $1,659.59 | $15,848.93 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $3,467.37 Median $17,782.79 Typical High $19,054.61 | Professional | None | $3,467.37 | $17,782.79 | $19,054.61 |
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 $2,884.03 Median $3,235.94 Typical High $7,079.46 | Professional | None | $2,884.03 | $3,235.94 | $7,079.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,162.28 Median $5,128.61 Typical High $6,456.54 | Professional | None | $3,162.28 | $5,128.61 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $2,511.89 Typical High $5,248.07 | Professional | None | $398.11 | $2,511.89 | $5,248.07 |
Pacific Source Setting Facility Modifier None Typical Low $3,090.30 Median $4,466.84 Typical High $4,897.79 | Facility | None | $3,090.30 | $4,466.84 | $4,897.79 |
Premera BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $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 $3,467.37 Median $4,897.79 Typical High $6,760.83 | Professional | None | $3,467.37 | $4,897.79 | $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 $2,951.21 Median $4,168.69 Typical High $7,762.47 | Professional | None | $2,951.21 | $4,168.69 | $7,762.47 |
Wellpoint Setting Professional Modifier None Typical Low $3,019.95 Median $3,162.28 Typical High $4,570.88 | Professional | None | $3,019.95 | $3,162.28 | $4,570.88 |
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 $1,584.89 Median $1,584.89 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $676.08 | Professional | 53 · Discontinued | $630.96 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $338.84 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $2,344.23 |
Where Washington sits
The same service costs 11.2 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 $35,827MD $3,193
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.