How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $955 · 10th to 90th $85 to $1,905
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 $1,995.26 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,995.26 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,995.26 | $1,995.26 |
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 $1,584.89 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,584.89 | $1,862.09 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $912.01 Typical High $1,202.26 | Professional | None | $83.18 | $912.01 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,737.80 | $2,041.74 | $3,715.35 |
Select Health Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,202.26 Median $2,187.76 Typical High $4,265.80 | Professional | None | $1,202.26 | $2,187.76 | $4,265.80 |
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 $1,288.25 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,584.89 | $2,884.03 |
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 $707.95 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $707.95 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $281.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,047.13 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $213.80 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $141.25 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $977.24 | $1,380.38 | $1,380.38 |
Where Utah 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.