How much rates vary
Facilitymedian $2,884 · 10th to 90th $603 to $6,607Professionalmedian $3,311 · 10th to 90th $1,738 to $4,677
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 $2,630.27 Median $5,888.44 Typical High $7,943.28 | Facility | None | $2,630.27 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,412.54 | $2,630.27 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $3,548.13 Typical High $4,365.16 | Professional | None | $1,659.59 | $3,548.13 | $4,365.16 |
Hally Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,187.76 Typical High $3,890.45 | Professional | None | $1,479.11 | $2,187.76 | $3,890.45 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $4,897.79 | Facility | None | $588.84 | $2,951.21 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $3,467.37 Typical High $11,481.54 | Professional | None | $1,819.70 | $3,467.37 | $11,481.54 |
Midlands Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,365.16 | Professional | None | $3,548.13 | $3,548.13 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $2,818.38 Median $3,890.45 Typical High $4,677.35 | Professional | None | $2,818.38 | $3,890.45 | $4,677.35 |
Oscar Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,951.21 Typical High $3,715.35 | Professional | None | $1,584.89 | $2,951.21 | $3,715.35 |
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 $1,659.59 Median $2,238.72 Typical High $4,265.80 | Professional | None | $1,659.59 | $2,238.72 | $4,265.80 |
Wellmark Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,630.78 | Professional | None | $3,311.31 | $3,311.31 | $3,630.78 |
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 $724.44 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $724.44 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $288.40 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,071.52 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $213.80 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $144.54 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,819.70 | $1,819.70 |
Where Iowa 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.