How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $1,995Professionalmedian $1,000 · 10th to 90th $631 to $1,413
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 $1,000.00 Median $1,380.38 Typical High $2,454.71 | Facility | None | $1,000.00 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | None | $812.83 | $1,000.00 | $1,000.00 |
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 $549.54 Median $1,000.00 Typical High $1,621.81 | Professional | None | $549.54 | $1,000.00 | $1,621.81 |
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 $630.96 Median $758.58 Typical High $1,445.44 | Professional | None | $630.96 | $758.58 | $1,445.44 |
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 $398.11 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $562.34 | $691.83 | $691.83 |
Where Arkansas sits
The same service costs 16.9 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 $23,956MD $1,413
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.