How much rates vary
Facilitymedian $1,230 · 10th to 90th $501 to $3,388Professionalmedian $1,202 · 10th to 90th $955 to $1,950
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 $1,380.38 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,202.26 | $1,202.26 | $1,288.25 |
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 $794.33 Median $1,698.24 Typical High $1,862.09 | Professional | None | $794.33 | $1,698.24 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $3,801.89 | Facility | None | $1,096.48 | $1,513.56 | $3,801.89 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $2,041.74 | Professional | None | $954.99 | $1,122.02 | $2,041.74 |
7 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 $602.56 Median $602.56 Typical High $645.65 | Professional | 52 · Reduced service | $602.56 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | 53 · Discontinued | $239.88 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $977.24 | Professional | 54 · Surgery only | $912.01 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $194.98 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $912.01 |
Qualchoice Setting Professional Modifier 59 · Distinct service Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 59 · Distinct service | $1,584.89 | $1,584.89 | $1,584.89 |
Where Arkansas sits
The same service costs 9.8 times more in Maine than in Arkansas. 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 $23,866AR $2,433
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.