How much rates vary
Facilitymedian $1,514 · 10th to 90th $537 to $251,189Professionalmedian $1,950 · 10th to 90th $427 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 $1,000.00 Median $2,089.30 Typical High $8,709.64 | Facility | None | $1,000.00 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,318.26 | $2,137.96 | $2,137.96 |
BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,778.28 | $2,511.89 |
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 $1,445.44 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,778.28 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $426.58 Typical High $2,137.96 | Professional | None | $33.11 | $426.58 | $2,137.96 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $251,188.64 | Facility | None | $602.56 | $2,041.74 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,584.89 | $1,778.28 | $2,454.71 |
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 $1,445.44 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,445.44 | $2,041.74 | $2,818.38 |
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 $691.83 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $691.83 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $275.42 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,023.29 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $204.17 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $138.04 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $954.99 | $1,513.56 | $1,513.56 |
Where New Mexico sits
The same service costs 8.5 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 $17,711MD $2,076
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.