How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $1,995Professionalmedian $813 · 10th to 90th $617 to $1,202
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 $812.83 Median $1,380.38 Typical High $2,454.71 | Facility | None | $812.83 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $812.83 | Professional | None | $630.96 | $812.83 | $812.83 |
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 $630.96 Median $1,000.00 Typical High $1,202.26 | Professional | None | $630.96 | $1,000.00 | $1,202.26 |
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 $616.60 Median $676.08 Typical High $1,288.25 | Professional | None | $616.60 | $676.08 | $1,288.25 |
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 $331.13 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $489.78 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $457.09 | $575.44 | $575.44 |
Where Arkansas sits
The same service costs 12.7 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 $16,761MD $1,321
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.