How much rates vary
Facilitymedian $1,230 · 10th to 90th $501 to $3,236Professionalmedian $1,202 · 10th to 90th $813 to $1,698
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 $1,513.56 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,513.56 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,202.26 | Professional | None | $977.24 | $1,202.26 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,023.29 | Facility | None | $501.19 | $501.19 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,230.27 Typical High $1,995.26 | Professional | None | $660.69 | $1,230.27 | $1,995.26 |
Qualchoice Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $3,801.89 | Facility | None | $1,096.48 | $1,513.56 | $3,801.89 |
United Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,778.28 | Professional | None | $812.83 | $933.25 | $1,778.28 |
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 $489.78 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $489.78 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $194.98 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $724.44 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $97.72 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $676.08 | $851.14 | $851.14 |
Where Arkansas sits
The same service costs 9.3 times more in Maine than in Florida. 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 $16,747FL $1,794
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.