How much rates vary
Facilitymedian $1,950 · 10th to 90th $501 to $6,457Professionalmedian $1,585 · 10th to 90th $1,175 to $2,692
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 $1,819.70 Typical High $3,715.35 | Facility | None | $1,288.25 | $1,819.70 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,584.89 | $1,995.26 |
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 $933.25 Median $2,630.27 Typical High $2,884.03 | Professional | None | $933.25 | $2,630.27 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $2,511.89 Typical High $7,079.46 | Facility | None | $1,659.59 | $2,511.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,570.40 | Professional | None | $1,148.15 | $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 $758.58 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $758.58 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $316.23 Typical High $323.59 | Professional | 53 · Discontinued | $302.00 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,174.90 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,148.15 | $1,174.90 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $234.42 Typical High $239.88 | Professional | 55 · Aftercare only | $229.09 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $151.36 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,096.48 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,096.48 | $1,122.02 |
Where Arkansas sits
The same service costs 13.5 times more in Maine than in Texas. 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 $34,179TX $2,531
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.