How much rates vary
Facilitymedian $1,122 · 10th to 90th $537 to $251,189Professionalmedian $1,122 · 10th to 90th $490 to $1,445
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 $933.25 Median $1,000.00 Typical High $7,762.47 | Facility | None | $933.25 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | None | $812.83 | $1,288.25 | $1,288.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,348.96 | Professional | None | $676.08 | $1,071.52 | $1,348.96 |
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 $851.14 Median $1,071.52 Typical High $1,412.54 | Professional | None | $851.14 | $1,071.52 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $257.04 Typical High $1,288.25 | Professional | None | $33.11 | $257.04 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $251,188.64 | Facility | None | $602.56 | $1,174.90 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,513.56 | Professional | None | $954.99 | $1,096.48 | $1,513.56 |
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 $870.96 Median $1,258.93 Typical High $1,698.24 | Professional | None | $870.96 | $1,258.93 | $1,698.24 |
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 $416.87 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $416.87 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $165.96 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $630.96 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $125.89 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $83.18 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $588.84 | $912.01 | $912.01 |
Where New Mexico sits
The same service costs 11.4 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 $16,997MD $1,496
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.