How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,445 to $3,311Professionalmedian $3,020 · 10th to 90th $85 to $3,548
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 Professional Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,495.41 | Professional | None | $1,698.24 | $2,511.89 | $5,495.41 |
BCBS Montana Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,235.94 | Professional | None | $1,995.26 | $3,019.95 | $3,235.94 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $3,467.37 | Facility | None | $2,691.53 | $3,019.95 | $3,467.37 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $3,235.94 | Professional | None | $1,949.84 | $3,019.95 | $3,235.94 |
Providence Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,754.23 Typical High $3,090.30 | Professional | None | $79.43 | $2,754.23 | $3,090.30 |
United Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,862.09 | Facility | None | $602.56 | $954.99 | $1,862.09 |
United Setting Professional Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $3,801.89 | Professional | None | $2,691.53 | $3,235.94 | $3,801.89 |
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 $891.25 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $891.25 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $1,096.48 Typical High $1,096.48 | Professional | 53 · Discontinued | $354.81 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $4,168.69 Typical High $4,168.69 | Professional | 54 · Surgery only | $1,318.26 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $831.76 Typical High $831.76 | Professional | 55 · Aftercare only | $263.03 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $177.83 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $3,890.45 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $1,230.27 | $3,890.45 | $3,890.45 |
Where Montana sits
The same service costs 7.2 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 $18,361MD $2,558
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.