How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $1,995Professionalmedian $1,738 · 10th to 90th $1,175 to $2,455
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 $1,071.52 Median $1,737.80 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,737.80 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,737.80 | $1,995.26 |
Ambetter Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $933.25 Median $1,737.80 Typical High $2,884.03 | Professional | None | $933.25 | $1,737.80 | $2,884.03 |
Qualchoice Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $1,174.90 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,348.96 | $2,511.89 |
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 $691.83 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $691.83 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $275.42 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,047.13 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,202.26 | $1,202.26 |
Where Arkansas sits
The same service costs 12.5 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 $24,646MD $1,975
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.