How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $1,995Professionalmedian $891 · 10th to 90th $676 to $1,288
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 $891.25 Median $1,380.38 Typical High $2,454.71 | Facility | None | $891.25 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $891.25 | Professional | None | $707.95 | $891.25 | $891.25 |
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 $660.69 Median $1,071.52 Typical High $1,348.96 | Professional | None | $660.69 | $1,071.52 | $1,348.96 |
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 $660.69 Median $741.31 Typical High $1,412.54 | Professional | None | $660.69 | $741.31 | $1,412.54 |
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 $354.81 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $141.25 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $107.15 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $70.79 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $501.19 | $630.96 | $630.96 |
Where Arkansas sits
The same service costs 12.3 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 $16,849MD $1,375
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.