How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $631 · 10th to 90th $83 to $1,096
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 $1,288.25 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,288.25 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $933.25 | $1,288.25 | $1,288.25 |
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 $1,071.52 Median $1,071.52 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,071.52 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $575.44 Typical High $812.83 | Professional | None | $81.28 | $575.44 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,479.11 | $1,584.89 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $776.25 Median $1,548.82 Typical High $2,511.89 | Professional | None | $776.25 | $1,548.82 | $2,511.89 |
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 $851.14 Median $1,023.29 Typical High $1,862.09 | Professional | None | $851.14 | $1,023.29 | $1,862.09 |
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 $467.74 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $467.74 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $186.21 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $707.95 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $141.25 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $93.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $660.69 | $891.25 | $891.25 |
Where Utah 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.