How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,072 to $7,943Professionalmedian $2,884 · 10th to 90th $1,349 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 $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 $1,348.96 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,949.84 | $1,949.84 |
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 $2,041.74 Median $2,691.53 Typical High $4,073.80 | Professional | None | $2,041.74 | $2,691.53 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $3,801.89 | Professional | None | $2,754.23 | $3,162.28 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $7,943.28 | Facility | None | $1,949.84 | $3,548.13 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $4,073.80 | Professional | None | $1,659.59 | $2,454.71 | $4,073.80 |
Pacific Source Setting Facility Modifier None Typical Low $1,737.80 Median $2,884.03 Typical High $3,090.30 | Facility | None | $1,737.80 | $2,884.03 | $3,090.30 |
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 $2,818.38 Typical High $4,466.84 | Professional | None | $79.43 | $2,818.38 | $4,466.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,951.21 Median $3,090.30 Typical High $4,677.35 | Professional | None | $2,951.21 | $3,090.30 | $4,677.35 |
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 $2,238.72 Median $3,235.94 Typical High $5,370.32 | Professional | None | $2,238.72 | $3,235.94 | $5,370.32 |
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 $977.24 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $977.24 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $389.05 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,380.38 |
Where Oregon sits
The same service costs 15.5 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 $34,449MD $2,222
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.