How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $1,995Professionalmedian $1,585 · 10th to 90th $1,230 to $2,512
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 $1,071.52 Median $1,621.81 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,621.81 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,348.96 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,023.29 | Facility | None | $501.19 | $501.19 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $2,137.96 Typical High $2,630.27 | Professional | None | $891.25 | $2,137.96 | $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 $1,202.26 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,548.82 | $2,630.27 |
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 $676.08 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $676.08 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,023.29 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $204.17 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $954.99 | $1,071.52 | $1,071.52 |
Where Arkansas sits
The same service costs 8.1 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 $15,945MD $1,975
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.