How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $871 · 10th to 90th $85 to $1,660
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 $1,778.28 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,778.28 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,778.28 | $1,778.28 |
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 $1,445.44 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,659.59 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $831.76 Typical High $1,096.48 | Professional | None | $83.18 | $831.76 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,862.09 | $2,344.23 |
Select Health Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $954.99 Median $1,905.46 Typical High $3,467.37 | Professional | None | $954.99 | $1,905.46 | $3,467.37 |
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 $1,148.15 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,445.44 | $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 $645.65 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $645.65 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $257.04 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $954.99 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $190.55 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $128.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $891.25 | $1,230.27 | $1,230.27 |
Where Utah 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.