How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $813 · 10th to 90th $112 to $1,514
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 $1,778.28 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,778.28 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,778.28 | $1,778.28 |
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 $1,445.44 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,513.56 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $776.25 Typical High $1,071.52 | Professional | None | $109.65 | $776.25 | $1,071.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,995.26 | $2,137.96 | $3,162.28 |
Select Health Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,000.00 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,000.00 | $2,041.74 | $3,311.31 |
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 $1,174.90 Median $1,380.38 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,380.38 | $2,570.40 |
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 $645.65 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $645.65 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $257.04 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $977.24 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $194.98 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $128.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $912.01 | $1,258.93 | $1,258.93 |
Where Utah sits
The same service costs 8.5 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 $16,489MD $1,943
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.