How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $2,089Professionalmedian $2,570 · 10th to 90th $1,905 to $3,715
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 $1,071.52 Median $1,862.09 Typical High $2,570.40 | Facility | None | $1,071.52 | $1,862.09 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,949.84 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,023.29 | Facility | None | $501.19 | $501.19 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $3,162.28 Typical High $3,801.89 | Professional | None | $1,548.82 | $3,162.28 | $3,801.89 |
United Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,995.26 | Facility | None | $281.84 | $457.09 | $1,995.26 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $3,981.07 | Professional | None | $1,905.46 | $2,137.96 | $3,981.07 |
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 $1,000.00 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,000.00 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $398.11 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,479.11 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $295.12 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $199.53 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,819.70 | $1,819.70 |
Where Arkansas sits
The same service costs 7.6 times more in Maine than in Texas. 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 $18,667TX $2,469
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.