How much rates vary
Facilitymedian $1,660 · 10th to 90th $501 to $4,467Professionalmedian $1,820 · 10th to 90th $1,259 to $2,455
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 $1,174.90 Median $1,698.24 Typical High $2,818.38 | Facility | None | $1,174.90 | $1,698.24 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,659.59 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,047.13 | Facility | None | $501.19 | $501.19 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,230.27 | $2,041.74 | $2,454.71 |
Qualchoice Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,511.89 | Professional | None | $2,137.96 | $2,137.96 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $5,248.07 | Facility | None | $1,412.54 | $1,995.26 | $5,248.07 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,380.38 | $2,570.40 |
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 $645.65 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $645.65 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $954.99 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $190.55 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $891.25 | $1,148.15 | $1,148.15 |
Where Arkansas sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.