How much rates vary
Facilitymedian $589 · 10th to 90th $282 to $1,995Professionalmedian $105 · 10th to 90th $76 to $182
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 $104.71 Median $1,071.52 Typical High $2,454.71 | Facility | None | $104.71 | $1,071.52 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $123.03 | Professional | None | $89.13 | $104.71 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $891.25 Typical High $1,122.02 | Facility | None | $588.84 | $891.25 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $190.55 | Professional | None | $81.28 | $177.83 | $190.55 |
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 $75.86 Median $91.20 Typical High $169.82 | Professional | None | $75.86 | $91.20 | $169.82 |
5 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 $50.12 Median $52.48 Typical High $57.54 | Professional | 52 · Reduced service | $50.12 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $23.44 | Professional | 53 · Discontinued | $20.42 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $79.43 Typical High $87.10 | Professional | 54 · Surgery only | $75.86 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $17.38 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $11.75 |
Where Arkansas sits
The same service costs 121.8 times more in Maine than in Montana. 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 $33,236MT $273
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.