How much rates vary
Facilitymedian $550 · 10th to 90th $309 to $2,089Professionalmedian $1,905 · 10th to 90th $1,445 to $3,090
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 $1,862.09 Typical High $3,090.30 | Facility | None | $1,288.25 | $1,862.09 | $3,090.30 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,548.82 | $1,862.09 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
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 $1,071.52 Median $2,511.89 Typical High $3,162.28 | Professional | None | $1,071.52 | $2,511.89 | $3,162.28 |
Qualchoice Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $1,412.54 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,995.26 | $3,162.28 |
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 $812.83 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $812.83 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $323.59 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,230.27 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $162.18 | $186.21 | $186.21 |
Where Arkansas sits
The same service costs 24.1 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 $53,525MD $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.