How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,445 to $2,692Professionalmedian $2,455 · 10th to 90th $79 to $2,884
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 $1,412.54 Median $4,466.84 Typical High $4,466.84 | Professional | None | $1,412.54 | $4,466.84 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,454.71 Typical High $2,630.27 | Professional | None | $1,621.81 | $2,454.71 | $2,630.27 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $2,818.38 | Facility | None | $2,187.76 | $2,454.71 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $2,630.27 | Professional | None | $1,584.89 | $2,454.71 | $2,630.27 |
Providence Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,238.72 Typical High $2,511.89 | Professional | None | $79.43 | $2,238.72 | $2,511.89 |
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 $2,187.76 Median $2,570.40 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,570.40 | $3,019.95 |
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 $707.95 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $707.95 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $288.40 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $3,388.44 Typical High $3,388.44 | Professional | 54 · Surgery only | $1,071.52 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $676.08 Typical High $676.08 | Professional | 55 · Aftercare only | $213.80 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $446.68 Typical High $446.68 | Professional | 56 · Pre-op care only | $141.25 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $3,162.28 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,000.00 | $3,162.28 | $3,162.28 |
Where Montana 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.