How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,000 to $8,511Professionalmedian $537 · 10th to 90th $85 to $1,000
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 $1,000.00 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,000.00 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,412.54 | Professional | None | $758.58 | $1,000.00 | $1,412.54 |
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 $933.25 Median $977.24 Typical High $1,513.56 | Professional | None | $933.25 | $977.24 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $512.86 Typical High $691.83 | Professional | None | $83.18 | $512.86 | $691.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,174.90 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $616.60 Median $1,202.26 Typical High $2,187.76 | Professional | None | $616.60 | $1,202.26 | $2,187.76 |
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 $741.31 Median $891.25 Typical High $1,659.59 | Professional | None | $741.31 | $891.25 | $1,659.59 |
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 $380.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $380.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $151.36 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $75.86 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $707.95 | $707.95 |
Where Utah sits
The same service costs 11.6 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 $23,484TX $2,029
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.