How much rates vary
Facilitymedian $1,096 · 10th to 90th $537 to $251,189Professionalmedian $1,023 · 10th to 90th $302 to $1,380
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 $870.96 Median $1,000.00 Typical High $7,762.47 | Facility | None | $870.96 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,202.26 | Professional | None | $758.58 | $1,202.26 | $1,202.26 |
BCBS New Mexico Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,348.96 | Professional | None | $741.31 | $1,000.00 | $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 $812.83 Median $1,000.00 Typical High $1,318.26 | Professional | None | $812.83 | $1,000.00 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $239.88 Typical High $1,202.26 | Professional | None | $33.11 | $239.88 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $251,188.64 | Facility | None | $602.56 | $1,122.02 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,412.54 | Professional | None | $870.96 | $1,023.29 | $1,412.54 |
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 $831.76 Median $1,174.90 Typical High $1,584.89 | Professional | None | $831.76 | $1,174.90 | $1,584.89 |
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 $389.05 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $389.05 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $158.49 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $588.84 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $117.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $77.62 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $549.54 | $851.14 | $851.14 |
Where New Mexico sits
The same service costs 11.8 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 $16,920MD $1,433
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.