How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $871 · 10th to 90th $85 to $1,698
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 $1,819.70 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,819.70 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,479.11 | $1,698.24 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $831.76 Typical High $1,122.02 | Professional | None | $83.18 | $831.76 | $1,122.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $3,467.37 | Professional | None | $1,584.89 | $1,862.09 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,122.02 Median $2,041.74 Typical High $3,981.07 | Professional | None | $1,122.02 | $2,041.74 | $3,981.07 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,691.53 | Professional | None | $1,174.90 | $1,479.11 | $2,691.53 |
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 $660.69 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $660.69 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $263.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $977.24 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $194.98 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $131.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $912.01 | $1,288.25 | $1,288.25 |
Where Utah 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.