How much rates vary
Facilitymedian $1,862 · 10th to 90th $603 to $6,607Professionalmedian $1,622 · 10th to 90th $851 to $2,344
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 $1,258.93 Median $5,888.44 Typical High $7,943.28 | Facility | None | $1,258.93 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $1,258.93 | Professional | None | $676.08 | $1,258.93 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,737.80 Typical High $2,137.96 | Professional | None | $851.14 | $1,737.80 | $2,137.96 |
Hally Health Setting Professional Modifier None Typical Low $707.95 Median $1,122.02 Typical High $2,344.23 | Professional | None | $707.95 | $1,122.02 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $4,897.79 | Facility | None | $588.84 | $1,659.59 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,698.24 Typical High $5,623.41 | Professional | None | $891.25 | $1,698.24 | $5,623.41 |
Midlands Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,659.59 | $1,737.80 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,905.46 | $2,398.83 |
Oscar Health Setting Professional Modifier None Typical Low $776.25 Median $1,445.44 Typical High $1,819.70 | Professional | None | $776.25 | $1,445.44 | $1,819.70 |
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 $794.33 Median $1,071.52 Typical High $2,041.74 | Professional | None | $794.33 | $1,071.52 | $2,041.74 |
Wellmark Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,621.81 | $1,621.81 | $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 $346.74 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $346.74 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $138.04 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $524.81 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $104.71 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $69.18 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $489.78 | $891.25 | $891.25 |
Where Iowa 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.