How much rates vary
Facilitymedian $525 · 10th to 90th $309 to $1,995Professionalmedian $1,000 · 10th to 90th $741 to $1,622
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 $1,513.56 Typical High $2,454.71 | Facility | None | $977.24 | $1,513.56 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | None | $851.14 | $977.24 | $977.24 |
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 $562.34 Median $1,318.26 Typical High $1,659.59 | Professional | None | $562.34 | $1,318.26 | $1,659.59 |
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 $724.44 Median $1,047.13 Typical High $1,659.59 | Professional | None | $724.44 | $1,047.13 | $1,659.59 |
6 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 $426.58 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $426.58 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $645.65 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $85.11 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $676.08 |
Where Arkansas sits
The same service costs 18.7 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 $26,826MD $1,433
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.