How much rates vary
Facilitymedian $3,162 · 10th to 90th $631 to $13,490Professionalmedian $1,230 · 10th to 90th $195 to $2,291
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 $2,290.87 Median $4,570.88 Typical High $12,022.64 | Facility | None | $2,290.87 | $4,570.88 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,737.80 | $2,290.87 | $2,290.87 |
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 $2,089.30 Median $2,238.72 Typical High $3,981.07 | Professional | None | $2,089.30 | $2,238.72 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $1,202.26 Typical High $1,584.89 | Professional | None | $194.98 | $1,202.26 | $1,584.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $4,365.16 | Professional | None | $2,290.87 | $2,691.53 | $4,365.16 |
Select Health Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,621.81 Median $2,951.21 Typical High $5,754.40 | Professional | None | $1,621.81 | $2,951.21 | $5,754.40 |
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 $1,698.24 Median $1,995.26 Typical High $3,801.89 | Professional | None | $1,698.24 | $1,995.26 | $3,801.89 |
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 $870.96 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $870.96 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $346.74 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,288.25 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $257.04 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $173.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,584.89 | $1,584.89 |
Where Utah sits
The same service costs 9.7 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 $24,899MD $2,558
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.