How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $1,000 · 10th to 90th $112 to $1,585
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 $2,089.30 Median $3,162.28 Typical High $6,025.60 | Facility | None | $2,089.30 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,137.96 | Professional | None | $1,479.11 | $2,089.30 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,862.09 | $1,949.84 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $977.24 Typical High $1,318.26 | Professional | None | $109.65 | $977.24 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,995.26 | $2,290.87 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Select Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $3,090.30 | Professional | None | $1,698.24 | $2,630.27 | $3,090.30 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $5,370.32 | Professional | None | $1,288.25 | $2,238.72 | $5,370.32 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,621.81 | $2,884.03 |
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 $812.83 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $812.83 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $323.59 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,230.27 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $245.47 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $162.18 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,479.11 | $1,479.11 |
Where Utah 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.