How much rates vary
Facilitymedian $1,479 · 10th to 90th $537 to $251,189Professionalmedian $1,995 · 10th to 90th $1,230 to $2,692
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 $1,698.24 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,698.24 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,445.44 | $2,089.30 | $2,398.83 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,949.84 | $2,691.53 |
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 $1,548.82 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,949.84 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $467.74 Typical High $2,344.23 | Professional | None | $33.11 | $467.74 | $2,344.23 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $251,188.64 | Facility | None | $602.56 | $2,187.76 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,698.24 | $1,995.26 | $2,691.53 |
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 $1,584.89 Median $2,290.87 Typical High $3,090.30 | Professional | None | $1,584.89 | $2,290.87 | $3,090.30 |
7 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 $758.58 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $758.58 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $302.00 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,148.15 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $229.09 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $151.36 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,659.59 | $1,659.59 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 59 · Distinct service | $1,445.44 | $1,445.44 | $1,445.44 |
Where New Mexico 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.