How much rates vary
Facilitymedian $1,445 · 10th to 90th $537 to $251,189Professionalmedian $1,479 · 10th to 90th $324 to $1,862
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 $1,174.90 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,174.90 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,659.59 | $1,659.59 |
BCBS New Mexico Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $1,905.46 | Professional | None | $912.01 | $1,380.38 | $1,905.46 |
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 $1,071.52 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,348.96 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $323.59 Typical High $1,621.81 | Professional | None | $33.11 | $323.59 | $1,621.81 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $251,188.64 | Facility | None | $602.56 | $1,513.56 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,380.38 | $1,905.46 |
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 $1,122.02 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,584.89 | $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 $524.81 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $524.81 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $208.93 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $794.33 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $158.49 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $104.71 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $741.31 | $1,148.15 | $1,148.15 |
Where New Mexico 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.