How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $2,042Professionalmedian $2,138 · 10th to 90th $1,585 to $3,090
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 $1,071.52 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,819.70 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,621.81 | $2,137.96 | $2,137.96 |
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 $1,445.44 Median $2,630.27 Typical High $3,162.28 | Professional | None | $1,445.44 | $2,630.27 | $3,162.28 |
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 $1,513.56 Median $1,737.80 Typical High $3,311.31 | Professional | None | $1,513.56 | $1,737.80 | $3,311.31 |
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 $812.83 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $812.83 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $323.59 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,202.26 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $245.47 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $162.18 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,479.11 | $1,479.11 |
Where Arkansas sits
The same service costs 7.6 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 $18,140MD $2,382
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.