How much rates vary
Facilitymedian $2,570 · 10th to 90th $447 to $6,310Professionalmedian $2,455 · 10th to 90th $1,950 to $16,218
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 $1,288.25 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,288.25 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $2,454.71 | Professional | None | $2,137.96 | $2,344.23 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $1,258.93 | Facility | None | $549.54 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,454.71 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $2,951.21 Typical High $5,888.44 | Facility | None | $398.11 | $2,951.21 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $16,218.10 | Professional | None | $1,995.26 | $2,570.40 | $16,218.10 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,995.26 Typical High $6,025.60 | Facility | None | $426.58 | $1,995.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,290.87 | $3,388.44 |
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 $1,071.52 Median $1,174.90 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,071.52 | $1,174.90 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $426.58 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,778.28 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,621.81 | $1,778.28 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $354.81 Typical High $363.08 | Professional | 55 · Aftercare only | $323.59 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $234.42 Typical High $239.88 | Professional | 56 · Pre-op care only | $213.80 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,659.59 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,659.59 | $1,698.24 |
Where Oklahoma sits
The same service costs 10.4 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 $29,734MD $2,853
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.