How much rates vary
Facilitymedian $513 · 10th to 90th $309 to $1,995Professionalmedian $1,820 · 10th to 90th $1,259 to $2,512
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 $1,174.90 Median $1,819.70 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,819.70 | $3,090.30 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,819.70 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,513.56 | $1,778.28 |
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 $977.24 Median $1,862.09 Typical High $3,019.95 | Professional | None | $977.24 | $1,862.09 | $3,019.95 |
Qualchoice Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,737.80 | $2,041.74 |
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 $1,202.26 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,380.38 | $2,630.27 |
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 $724.44 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $724.44 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $288.40 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $218.78 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $144.54 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,258.93 | $1,258.93 |
Where Arkansas sits
The same service costs 14.0 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 $28,122MD $2,008
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.