How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,000 to $6,918Professionalmedian $851 · 10th to 90th $83 to $1,549
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 $1,862.09 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,862.09 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,698.24 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $831.76 Typical High $1,071.52 | Professional | None | $83.18 | $831.76 | $1,071.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,698.24 | $1,905.46 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,445.44 | $2,089.30 | $2,454.71 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $6,165.95 | Professional | None | $1,122.02 | $1,819.70 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,380.38 | $2,454.71 |
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 $691.83 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $691.83 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $275.42 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,023.29 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $208.93 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $138.04 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $977.24 | $1,288.25 | $1,288.25 |
Where Utah sits
The same service costs 11.9 times more in Maine than in Delaware. 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 $28,614DE $2,410
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.