How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $1,995Professionalmedian $1,862 · 10th to 90th $1,288 to $2,692
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 $1,698.24 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,698.24 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,659.59 | $1,659.59 |
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 $933.25 Median $2,290.87 Typical High $2,818.38 | Professional | None | $933.25 | $2,290.87 | $2,818.38 |
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 $1,862.09 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,862.09 | $2,754.23 |
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 $707.95 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $707.95 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $288.40 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $213.80 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,174.90 | $1,174.90 |
Where Arkansas sits
The same service costs 7.5 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 $16,075MD $2,147
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.