How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $1,995Professionalmedian $1,349 · 10th to 90th $1,000 to $2,089
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 $1,584.89 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,584.89 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,023.29 | Facility | None | $501.19 | $501.19 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,659.59 Typical High $2,089.30 | Professional | None | $812.83 | $1,659.59 | $2,089.30 |
United Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,995.26 | Facility | None | $281.84 | $457.09 | $1,995.26 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,258.93 | $2,137.96 |
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 $512.86 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $512.86 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $204.17 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $776.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $154.88 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $102.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $724.44 | $933.25 | $933.25 |
Where Arkansas sits
The same service costs 15.4 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 $28,500MD $1,851
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.