How much rates vary
Facilitymedian $1,778 · 10th to 90th $1,047 to $1,950Professionalmedian $1,778 · 10th to 90th $85 to $2,042
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 $1,023.29 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,023.29 | $3,162.28 | $3,162.28 |
BCBS Montana Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,778.28 | $1,862.09 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,041.74 | Facility | None | $1,548.82 | $1,778.28 | $2,041.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,778.28 | $1,905.46 |
Providence Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,584.89 Typical High $1,778.28 | Professional | None | $79.43 | $1,584.89 | $1,778.28 |
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 $1,548.82 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,819.70 | $2,137.96 |
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 $512.86 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $512.86 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $204.17 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $776.25 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $154.88 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $102.33 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $724.44 | $2,238.72 | $2,238.72 |
Where Montana sits
The same service costs 10.0 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 $17,294MD $1,737
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.