How much rates vary
Facilitymedian $537 · 10th to 90th $309 to $2,138Professionalmedian $1,622 · 10th to 90th $1,096 to $2,291
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 $3,019.95 | Facility | None | $1,174.90 | $1,819.70 | $3,019.95 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,621.81 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,047.13 | Facility | None | $501.19 | $501.19 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,691.53 | Professional | None | $891.25 | $1,659.59 | $2,691.53 |
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 $1,071.52 Median $1,258.93 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,258.93 | $2,344.23 |
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 $645.65 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $977.24 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $194.98 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $1,148.15 | $1,148.15 |
Where Arkansas sits
The same service costs 14.8 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 $28,001MD $1,894
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.