How much rates vary
Facilitymedian $1,000 · 10th to 90th $537 to $251,189Professionalmedian $933 · 10th to 90th $204 to $1,175
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 $741.31 Median $1,000.00 Typical High $7,762.47 | Facility | None | $741.31 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,023.29 | Professional | None | $660.69 | $1,023.29 | $1,023.29 |
BCBS New Mexico Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,174.90 | Professional | None | $616.60 | $851.14 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $707.95 | Facility | None | $537.03 | $602.56 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,148.15 | Professional | None | $691.83 | $851.14 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $204.17 Typical High $1,023.29 | Professional | None | $33.11 | $204.17 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $251,188.64 | Facility | None | $602.56 | $977.24 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,174.90 | Professional | None | $741.31 | $891.25 | $1,174.90 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,412.54 Typical High $10,471.29 | Facility | None | $407.38 | $1,412.54 | $10,471.29 |
United Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,348.96 | Professional | None | $707.95 | $977.24 | $1,348.96 |
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 $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $331.13 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $131.83 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $489.78 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $100.00 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $66.07 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $457.09 | $724.44 | $724.44 |
Where New Mexico 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.