How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $1,995Professionalmedian $1,905 · 10th to 90th $1,413 to $2,818
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 $1,071.52 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,819.70 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,905.46 | $1,905.46 |
Ambetter Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,023.29 | Facility | None | $501.19 | $501.19 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,174.90 | $2,344.23 | $2,818.38 |
Qualchoice Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
United Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,995.26 | Facility | None | $281.84 | $457.09 | $1,995.26 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,584.89 | $2,951.21 |
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 $741.31 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $741.31 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $295.12 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,096.48 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $218.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $147.91 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,318.26 | $1,318.26 |
Where Arkansas sits
The same service costs 8.1 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 $2,222
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.