How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,778 to $9,120Professionalmedian $2,884 · 10th to 90th $1,514 to $4,365
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 $2,238.72 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,238.72 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,230.27 | $2,238.72 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $3,090.30 Typical High $3,801.89 | Professional | None | $1,479.11 | $3,090.30 | $3,801.89 |
Hally Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $4,786.30 | Professional | None | $1,288.25 | $2,089.30 | $4,786.30 |
Medica Setting Facility Modifier None Typical Low $1,862.09 Median $3,388.44 Typical High $8,912.51 | Facility | None | $1,862.09 | $3,388.44 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $3,019.95 Typical High $10,000.00 | Professional | None | $1,584.89 | $3,019.95 | $10,000.00 |
Midlands Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,801.89 | Professional | None | $3,090.30 | $3,090.30 | $3,801.89 |
Midlands Setting Professional Modifier None Typical Low $2,454.71 Median $3,388.44 Typical High $4,265.80 | Professional | None | $2,454.71 | $3,388.44 | $4,265.80 |
Oscar Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,511.89 Typical High $3,235.94 | Professional | None | $1,348.96 | $2,511.89 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,466.84 Typical High $9,332.54 | Facility | None | $1,584.89 | $4,466.84 | $9,332.54 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $3,715.35 | Professional | None | $1,445.44 | $1,949.84 | $3,715.35 |
Wellmark Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,162.28 | Professional | None | $2,818.38 | $2,818.38 | $3,162.28 |
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 $630.96 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $630.96 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $251.19 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $933.25 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $186.21 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $125.89 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $870.96 | $1,584.89 | $1,584.89 |
Where Iowa 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.