How much rates vary
Facilitymedian $2,042 · 10th to 90th $501 to $10,471Professionalmedian $1,230 · 10th to 90th $166 to $2,239
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 $3,801.89 Typical High $9,772.37 | Facility | None | $1,122.02 | $3,801.89 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,621.81 | $1,905.46 |
BCBS Texas Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,659.59 | $2,137.96 | $2,818.38 |
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 $1,698.24 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,698.24 | $2,089.30 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $15,488.17 | Professional | None | $12,589.25 | $12,589.25 | $15,488.17 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,454.71 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,454.71 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,621.81 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $316.23 Typical High $1,698.24 | Professional | None | $158.49 | $316.23 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $1,995.26 Typical High $251,188.64 | Facility | None | $851.14 | $1,995.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,698.24 | $2,089.30 | $2,951.21 |
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 $1,445.44 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,862.09 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $758.58 Median $831.76 Typical High $954.99 | Professional | 52 · Reduced service | $758.58 | $831.76 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $338.84 Typical High $380.19 | Professional | 53 · Discontinued | $302.00 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,258.93 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,174.90 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,318.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $831.76 Typical High $954.99 | Professional | 52 · Reduced service | $758.58 | $831.76 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $338.84 Typical High $380.19 | Professional | 53 · Discontinued | $302.00 | $338.84 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,258.93 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,258.93 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,174.90 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,318.26 |
Where Texas 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.