How much rates vary
Facilitymedian $1,023 · 10th to 90th $537 to $251,189Professionalmedian $1,023 · 10th to 90th $224 to $1,259
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 $812.83 Median $1,000.00 Typical High $7,762.47 | Facility | None | $812.83 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | None | $724.44 | $1,148.15 | $1,148.15 |
BCBS New Mexico Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,348.96 | Professional | None | $676.08 | $954.99 | $1,348.96 |
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 $776.25 Median $933.25 Typical High $1,258.93 | Professional | None | $776.25 | $933.25 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $223.87 Typical High $1,122.02 | Professional | None | $33.11 | $223.87 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,047.13 Typical High $251,188.64 | Facility | None | $602.56 | $1,047.13 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,318.26 | Professional | None | $812.83 | $954.99 | $1,318.26 |
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 $776.25 Median $1,096.48 Typical High $1,513.56 | Professional | None | $776.25 | $1,096.48 | $1,513.56 |
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 $363.08 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $363.08 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $147.91 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $549.54 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $109.65 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $72.44 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $512.86 | $794.33 | $794.33 |
Where New Mexico 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.