How much rates vary
Facilitymedian $1,175 · 10th to 90th $537 to $251,189Professionalmedian $1,175 · 10th to 90th $263 to $1,514
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 $933.25 Median $1,000.00 Typical High $7,762.47 | Facility | None | $933.25 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,318.26 Typical High $1,318.26 | Professional | None | $812.83 | $1,318.26 | $1,318.26 |
BCBS New Mexico Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,513.56 | Professional | None | $724.44 | $1,096.48 | $1,513.56 |
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 $870.96 Median $1,096.48 Typical High $1,445.44 | Professional | None | $870.96 | $1,096.48 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $263.03 Typical High $1,318.26 | Professional | None | $33.11 | $263.03 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $251,188.64 | Facility | None | $602.56 | $1,230.27 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,513.56 | Professional | None | $933.25 | $1,096.48 | $1,513.56 |
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 $891.25 Median $1,258.93 Typical High $1,737.80 | Professional | None | $891.25 | $1,258.93 | $1,737.80 |
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 $416.87 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $416.87 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $165.96 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $630.96 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $125.89 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $83.18 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $588.84 | $912.01 | $912.01 |
Where New Mexico sits
The same service costs 11.4 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 $16,997MD $1,496
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.