How much rates vary
Facilitymedian $513 · 10th to 90th $309 to $1,995Professionalmedian $1,698 · 10th to 90th $1,148 to $2,455
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 $1,071.52 Median $1,698.24 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,698.24 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,698.24 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,000.00 | Facility | None | $501.19 | $501.19 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,698.24 Typical High $2,754.23 | Professional | None | $933.25 | $1,698.24 | $2,754.23 |
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 $1,122.02 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,318.26 | $2,454.71 |
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 $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $1,174.90 | $1,174.90 |
Where Arkansas sits
The same service costs 9.0 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 $17,266MD $1,911
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.