How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,698 to $5,129Professionalmedian $3,388 · 10th to 90th $1,778 to $4,898
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 $2,238.72 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,238.72 | $2,398.83 | $2,398.83 |
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 $1,862.09 Median $2,951.21 Typical High $4,897.79 | Professional | None | $1,862.09 | $2,951.21 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $3,715.35 Typical High $4,570.88 | Professional | None | $3,235.94 | $3,715.35 | $4,570.88 |
Moda Health Setting Facility Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $7,943.28 | Facility | None | $2,511.89 | $4,365.16 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,884.03 Typical High $4,073.80 | Professional | None | $2,398.83 | $2,884.03 | $4,073.80 |
Pacific Source Setting Facility Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $3,715.35 | Facility | None | $2,137.96 | $3,467.37 | $3,715.35 |
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 $3,388.44 Typical High $5,011.87 | Professional | None | $79.43 | $3,388.44 | $5,011.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $9,549.93 | Facility | None | $9,549.93 | $9,549.93 | $9,549.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,467.37 Median $3,715.35 Typical High $4,786.30 | Professional | None | $3,467.37 | $3,715.35 | $4,786.30 |
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 $2,137.96 Median $3,311.31 Typical High $5,495.41 | Professional | None | $2,137.96 | $3,311.31 | $5,495.41 |
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 $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,047.13 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $426.58 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,584.89 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $316.23 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $478.63 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,659.59 |
Where Oregon sits
The same service costs 14.4 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 $34,547MD $2,395
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.