How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,288 to $8,128Professionalmedian $708 · 10th to 90th $93 to $1,479
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 $1,513.56 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,513.56 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,513.56 | $2,187.76 |
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 $1,348.96 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,479.11 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $645.65 Typical High $891.25 | Professional | None | $85.11 | $645.65 | $891.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,698.24 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $912.01 Median $1,698.24 Typical High $2,398.83 | Professional | None | $912.01 | $1,698.24 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,288.25 | $2,398.83 |
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 $549.54 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $549.54 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $218.78 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $831.76 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $165.96 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $109.65 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $776.25 | $1,047.13 | $1,047.13 |
Where Utah sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.