How much rates vary
Facilitymedian $501 · 10th to 90th $302 to $1,995Professionalmedian $355 · 10th to 90th $240 to $501
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 $354.81 Median $1,380.38 Typical High $2,454.71 | Facility | None | $354.81 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $354.81 | Professional | None | $251.19 | $354.81 | $354.81 |
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 $251.19 Median $398.11 Typical High $501.19 | Professional | None | $251.19 | $398.11 | $501.19 |
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 $239.88 Median $288.40 Typical High $537.03 | Professional | None | $239.88 | $288.40 | $537.03 |
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 $125.89 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $125.89 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $50.12 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $190.55 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $38.02 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.12 | $35.48 | $35.48 |
Where Arkansas sits
The same service costs 32.0 times more in Maine than in Montana. 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 $26,674MT $834
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.