How much rates vary
Facilitymedian $3,388 · 10th to 90th $603 to $10,965Professionalmedian $437 · 10th to 90th $56 to $3,548
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 $3,715.35 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,454.71 | $2,691.53 | $3,311.31 |
BCBS Texas Setting Facility Modifier None Typical Low $2,754.23 Median $5,011.87 Typical High $14,125.38 | Facility | None | $2,754.23 | $5,011.87 | $14,125.38 |
BCBS Texas Setting Professional Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $4,265.80 | Professional | None | $2,454.71 | $3,090.30 | $4,265.80 |
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 $2,754.23 Median $3,162.28 Typical High $4,466.84 | Professional | None | $2,754.23 | $3,162.28 | $4,466.84 |
Lucent Health Setting Professional Modifier None Typical Low $19,498.45 Median $19,498.45 Typical High $20,417.38 | Professional | None | $19,498.45 | $19,498.45 | $20,417.38 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,090.30 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $3,548.13 | Professional | None | $2,454.71 | $2,691.53 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $346.74 Typical High $2,187.76 | Professional | None | $50.12 | $346.74 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,398.83 Typical High $251,188.64 | Facility | None | $812.83 | $2,398.83 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $4,570.88 | Professional | None | $2,754.23 | $3,235.94 | $4,570.88 |
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 $2,089.30 Median $2,818.38 Typical High $4,168.69 | Professional | None | $2,089.30 | $2,818.38 | $4,168.69 |
Wellpoint Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
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 $1,230.27 Median $1,348.96 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,230.27 | $1,348.96 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | 53 · Discontinued | $489.78 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,041.74 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,862.09 | $2,041.74 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $407.38 Typical High $457.09 | Professional | 55 · Aftercare only | $371.54 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 56 · Pre-op care only | $245.47 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,905.46 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,905.46 | $2,137.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,230.27 Median $1,348.96 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,230.27 | $1,348.96 | $1,548.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | 53 · Discontinued | $489.78 | $537.03 | $616.60 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,041.74 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,862.09 | $2,041.74 | $2,290.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $407.38 Typical High $457.09 | Professional | 55 · Aftercare only | $371.54 | $407.38 | $457.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 56 · Pre-op care only | $245.47 | $269.15 | $309.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,905.46 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,905.46 | $2,137.96 |
Where Texas sits
The same service costs 12.3 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 $36,075WA $2,929
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.