How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $1,000 · 10th to 90th $112 to $1,549
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 $2,041.74 Median $3,162.28 Typical High $6,025.60 | Facility | None | $2,041.74 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,584.89 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,778.28 | $1,905.46 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $954.99 Typical High $1,318.26 | Professional | None | $109.65 | $954.99 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $2,570.40 | Professional | None | $1,949.84 | $2,238.72 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $3,019.95 | Professional | None | $1,659.59 | $2,570.40 | $3,019.95 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $4,073.80 | Professional | None | $1,258.93 | $2,187.76 | $4,073.80 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,584.89 | $2,884.03 |
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 $794.33 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $794.33 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $316.23 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,202.26 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $239.88 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $158.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,445.44 | $1,445.44 |
Where Utah 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.