How much rates vary
Facilitymedian $562 · 10th to 90th $302 to $1,380Professionalmedian $1,445 · 10th to 90th $1,230 to $2,692
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 $1,819.70 Typical High $1,995.26 | Facility | None | $1,819.70 | $1,819.70 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,445.44 | $2,754.23 |
CareFirst Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,348.96 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,981.07 | Professional | None | $1,288.25 | $1,548.82 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,412.54 | $2,290.87 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,202.26 | $1,778.28 | $3,311.31 |
Wellpoint Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,071.52 | $1,862.09 |
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 $707.95 Median $707.95 Typical High $724.44 | Professional | 52 · Reduced service | $707.95 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 53 · Discontinued | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $213.80 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,000.00 |
Where Maryland 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.