How much rates vary
Facilitymedian $501 · 10th to 90th $282 to $1,660Professionalmedian $1,738 · 10th to 90th $1,175 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 $1,737.80 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,737.80 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,380.38 | $1,737.80 | $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 $1,737.80 Typical High $2,818.38 | Professional | None | $933.25 | $1,737.80 | $2,818.38 |
United Setting Facility Modifier None Typical Low $269.15 Median $346.74 Typical High $1,513.56 | Facility | None | $269.15 | $346.74 | $1,513.56 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,318.26 | $2,511.89 |
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 $691.83 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $691.83 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $275.42 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,047.13 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,202.26 | $1,202.26 |
Where Arkansas sits
The same service costs 13.1 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 $24,687MD $1,882
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.