How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $646 · 10th to 90th $59 to $1,000
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 $1,318.26 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,318.26 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,318.26 | $1,318.26 |
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 $1,174.90 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,230.27 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $630.96 Typical High $870.96 | Professional | None | $56.23 | $630.96 | $870.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,445.44 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,698.24 | $1,995.26 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $831.76 Median $1,445.44 Typical High $2,951.21 | Professional | None | $831.76 | $1,445.44 | $2,951.21 |
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 $870.96 Median $1,023.29 Typical High $1,819.70 | Professional | None | $870.96 | $1,023.29 | $1,819.70 |
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 $512.86 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $512.86 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $204.17 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $776.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $154.88 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $102.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $724.44 | $933.25 | $933.25 |
Where Utah sits
The same service costs 10.6 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 $17,137MD $1,609
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.