How much rates vary
Facilitymedian $1,479 · 10th to 90th $537 to $251,189Professionalmedian $2,344 · 10th to 90th $513 to $2,951
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 $1,000.00 Median $1,862.09 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,862.09 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $2,630.27 | Professional | None | $1,659.59 | $2,454.71 | $2,630.27 |
Ambetter Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $2,951.21 | Professional | None | $1,258.93 | $2,137.96 | $2,951.21 |
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 $1,737.80 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,737.80 | $2,137.96 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $512.86 Typical High $2,570.40 | Professional | None | $33.11 | $512.86 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $251,188.64 | Facility | None | $602.56 | $2,398.83 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,905.46 | $2,187.76 | $3,019.95 |
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 $1,737.80 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,511.89 | $3,467.37 |
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 $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $831.76 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $331.13 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,258.93 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $251.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $165.96 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,819.70 | $1,819.70 |
Where New Mexico 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.