How much rates vary
Facilitymedian $513 · 10th to 90th $309 to $1,995Professionalmedian $1,862 · 10th to 90th $1,259 to $2,692
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 $1,819.70 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,819.70 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,698.24 | $1,862.09 | $1,862.09 |
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 $1,023.29 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,023.29 | $1,905.46 | $3,090.30 |
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 $1,258.93 Median $1,445.44 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,445.44 | $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 $758.58 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $758.58 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $302.00 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $151.36 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,318.26 | $1,318.26 |
Where Arkansas sits
The same service costs 12.0 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 $24,859MD $2,076
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.