How much rates vary
Facilitymedian $3,020 · 10th to 90th $603 to $6,607Professionalmedian $4,266 · 10th to 90th $2,239 to $6,166
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 $3,235.94 Median $5,888.44 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $3,235.94 Typical High $3,235.94 | Professional | None | $1,778.28 | $3,235.94 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $4,466.84 Typical High $5,370.32 | Professional | None | $2,089.30 | $4,466.84 | $5,370.32 |
Hally Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,884.03 Typical High $6,165.95 | Professional | None | $1,819.70 | $2,884.03 | $6,165.95 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $3,162.28 Typical High $5,623.41 | Facility | None | $588.84 | $3,162.28 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $2,290.87 Median $4,365.16 Typical High $14,454.40 | Professional | None | $2,290.87 | $4,365.16 | $14,454.40 |
Midlands Setting Professional Modifier None Typical Low $4,365.16 Median $4,466.84 Typical High $5,495.41 | Professional | None | $4,365.16 | $4,466.84 | $5,495.41 |
Midlands Setting Professional Modifier None Typical Low $3,467.37 Median $4,897.79 Typical High $6,165.95 | Professional | None | $3,467.37 | $4,897.79 | $6,165.95 |
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 $2,089.30 Median $2,818.38 Typical High $5,370.32 | Professional | None | $2,089.30 | $2,818.38 | $5,370.32 |
Wellmark Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,570.88 | Professional | None | $4,073.80 | $4,073.80 | $4,570.88 |
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 $891.25 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $891.25 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $354.81 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,318.26 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $269.15 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $177.83 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,230.27 | $2,290.87 | $2,290.87 |
Where Iowa sits
The same service costs 6.9 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 $18,419MD $2,652
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.