How much rates vary
Facilitymedian $1,000 · 10th to 90th $74 to $7,244Professionalmedian $692 · 10th to 90th $105 to $1,549
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 $977.24 Median $3,715.35 Typical High $9,120.11 | Facility | None | $977.24 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,148.15 | Professional | None | $812.83 | $891.25 | $1,148.15 |
BCBS Texas Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,659.59 | Professional | None | $891.25 | $1,122.02 | $1,659.59 |
Christus Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
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 $1,023.29 Median $1,174.90 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,174.90 | $1,737.80 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $12,589.25 Typical High $12,589.25 | Professional | None | $8,709.64 | $12,589.25 | $12,589.25 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $6,918.31 | Facility | None | $933.25 | $1,905.46 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,412.54 | Professional | None | $812.83 | $891.25 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $933.25 | Professional | None | $91.20 | $165.96 | $933.25 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $251,188.64 | Facility | None | $812.83 | $1,479.11 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,202.26 | $1,737.80 |
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 $794.33 Median $1,071.52 Typical High $1,621.81 | Professional | None | $794.33 | $1,071.52 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
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 $407.38 Median $436.52 Typical High $512.86 | Professional | 52 · Reduced service | $407.38 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $162.18 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $436.52 Typical High $512.86 | Professional | 52 · Reduced service | $407.38 | $436.52 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $162.18 | $177.83 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $660.69 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $102.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $707.95 |
Where Texas sits
The same service costs 9.8 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 $16,204MD $1,659
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.