How much rates vary
Facilitymedian $2,884 · 10th to 90th $603 to $6,607Professionalmedian $3,388 · 10th to 90th $1,738 to $4,898
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 $2,511.89 Median $5,888.44 Typical High $7,943.28 | Facility | None | $2,511.89 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,380.38 | $2,511.89 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $3,467.37 Typical High $4,265.80 | Professional | None | $1,621.81 | $3,467.37 | $4,265.80 |
Hally Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $4,897.79 | Professional | None | $1,445.44 | $2,238.72 | $4,897.79 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $4,897.79 | Facility | None | $588.84 | $2,951.21 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $3,388.44 Typical High $11,220.18 | Professional | None | $1,778.28 | $3,388.44 | $11,220.18 |
Midlands Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,265.80 | Professional | None | $3,467.37 | $3,467.37 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $2,754.23 Median $3,801.89 Typical High $4,677.35 | Professional | None | $2,754.23 | $3,801.89 | $4,677.35 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,918.31 | Facility | None | $588.84 | $2,344.23 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $4,168.69 | Professional | None | $1,621.81 | $2,187.76 | $4,168.69 |
Wellmark Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,548.13 | Professional | None | $3,162.28 | $3,162.28 | $3,548.13 |
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 $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $691.83 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $281.84 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,047.13 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $208.93 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $138.04 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $977.24 | $1,778.28 | $1,778.28 |
Where Iowa sits
The same service costs 8.2 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 $17,891MD $2,184
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.