How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,820 to $11,220Professionalmedian $977 · 10th to 90th $110 to $1,585
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 $1,819.70 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,819.70 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,819.70 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,698.24 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $933.25 Typical High $1,174.90 | Professional | None | $109.65 | $933.25 | $1,174.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,737.80 | $1,995.26 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $2,754.23 | Professional | None | $1,479.11 | $2,344.23 | $2,754.23 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $4,265.80 | Professional | None | $1,148.15 | $1,949.84 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,412.54 | $2,511.89 |
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 $707.95 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $707.95 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $281.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,071.52 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $213.80 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $141.25 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,288.25 | $1,288.25 |
Where Utah 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.