How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $1,995Professionalmedian $1,072 · 10th to 90th $776 to $1,820
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 $954.99 Median $1,071.52 Typical High $1,071.52 | Professional | None | $954.99 | $1,071.52 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $645.65 Median $1,584.89 Typical High $1,949.84 | Professional | None | $645.65 | $1,584.89 | $1,949.84 |
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 $758.58 Median $933.25 Typical High $1,819.70 | Professional | None | $758.58 | $933.25 | $1,819.70 |
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 $478.63 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $478.63 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $724.44 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $95.50 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $676.08 | $741.31 | $741.31 |
Where Arkansas sits
The same service costs 10.1 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 $16,050AR $1,584
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.