How much rates vary
Facilitymedian $550 · 10th to 90th $309 to $2,089Professionalmedian $1,698 · 10th to 90th $1,288 to $2,754
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 $1,288.25 Median $1,819.70 Typical High $3,090.30 | Facility | None | $1,288.25 | $1,819.70 | $3,090.30 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,000.00 | Facility | None | $501.19 | $501.19 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $2,290.87 Typical High $2,884.03 | Professional | None | $977.24 | $2,290.87 | $2,884.03 |
United Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,995.26 | Facility | None | $281.84 | $457.09 | $1,995.26 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,778.28 | $2,818.38 |
5 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 $724.44 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $724.44 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,096.48 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $218.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $169.82 | $169.82 |
Where Arkansas sits
The same service costs 25.6 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 $53,236MD $2,076
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.