How much rates vary
Facilitymedian $1,950 · 10th to 90th $1,148 to $2,138Professionalmedian $1,905 · 10th to 90th $79 to $2,239
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 Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $3,467.37 | Professional | None | $1,071.52 | $1,318.26 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,905.46 | $2,041.74 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,238.72 | Facility | None | $1,698.24 | $1,949.84 | $2,238.72 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,949.84 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,778.28 Typical High $1,949.84 | Professional | None | $79.43 | $1,778.28 | $1,949.84 |
United Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,862.09 | Facility | None | $602.56 | $954.99 | $1,862.09 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,995.26 | $2,344.23 |
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 $562.34 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $562.34 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $223.87 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $831.76 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $165.96 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $112.20 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $776.25 | $2,454.71 | $2,454.71 |
Where Montana sits
The same service costs 5.9 times more in Alabama 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
AL $10,682MD $1,821
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.