How much rates vary
Facilitymedian $1,023 · 10th to 90th $537 to $251,189Professionalmedian $1,047 · 10th to 90th $229 to $1,318
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 $831.76 Median $1,000.00 Typical High $7,762.47 | Facility | None | $831.76 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | None | $741.31 | $1,174.90 | $1,174.90 |
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 $758.58 Median $954.99 Typical High $1,288.25 | Professional | None | $758.58 | $954.99 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $229.09 Typical High $1,148.15 | Professional | None | $33.11 | $229.09 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,047.13 Typical High $251,188.64 | Facility | None | $602.56 | $1,047.13 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,348.96 | Professional | None | $812.83 | $977.24 | $1,348.96 |
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 $776.25 Median $1,122.02 Typical High $1,513.56 | Professional | None | $776.25 | $1,122.02 | $1,513.56 |
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 $371.54 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $371.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $147.91 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $562.34 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $112.20 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $74.13 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $524.81 | $812.83 | $812.83 |
Where New Mexico sits
The same service costs 6.1 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 $8,436MD $1,394
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.