How much rates vary
Facilitymedian $1,479 · 10th to 90th $537 to $251,189Professionalmedian $2,138 · 10th to 90th $457 to $2,630
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 $1,659.59 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,659.59 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,479.11 | $2,344.23 | $2,344.23 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,905.46 | $2,754.23 |
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 $1,548.82 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,905.46 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $457.09 Typical High $2,290.87 | Professional | None | $33.11 | $457.09 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,137.96 Typical High $251,188.64 | Facility | None | $602.56 | $2,137.96 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,698.24 | $1,949.84 | $2,691.53 |
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 $1,548.82 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,548.82 | $2,238.72 | $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 $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $741.31 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $295.12 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,122.02 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $223.87 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $147.91 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,621.81 | $1,621.81 |
Where New Mexico 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.