How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $912 · 10th to 90th $85 to $1,905
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 $1,905.46 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,905.46 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,905.46 | $2,691.53 |
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 $1,548.82 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,819.70 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $870.96 Typical High $1,148.15 | Professional | None | $83.18 | $870.96 | $1,148.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $3,630.78 | Professional | None | $1,659.59 | $1,949.84 | $3,630.78 |
Select Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $4,073.80 | Professional | None | $1,148.15 | $2,089.30 | $4,073.80 |
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 $1,230.27 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,548.82 | $2,754.23 |
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 $676.08 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $676.08 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $269.15 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,023.29 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $204.17 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $134.90 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $954.99 | $1,348.96 | $1,348.96 |
Where Utah 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.