How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $1,349 · 10th to 90th $170 to $2,630
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 $2,630.27 Median $3,162.28 Typical High $6,025.60 | Facility | None | $2,630.27 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,630.27 | $2,630.27 |
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 $2,187.76 Median $2,238.72 Typical High $4,073.80 | Professional | None | $2,187.76 | $2,238.72 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,288.25 Typical High $1,737.80 | Professional | None | $165.96 | $1,288.25 | $1,737.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $5,495.41 | Professional | None | $3,019.95 | $3,548.13 | $5,495.41 |
Select Health Setting Facility Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,570.88 | $4,570.88 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,621.81 Median $3,162.28 Typical High $6,165.95 | Professional | None | $1,621.81 | $3,162.28 | $6,165.95 |
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 $1,778.28 Median $2,089.30 Typical High $3,890.45 | Professional | None | $1,778.28 | $2,089.30 | $3,890.45 |
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 $977.24 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $977.24 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $389.05 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,445.44 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $295.12 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $194.98 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,862.09 | $1,862.09 |
Where Utah sits
The same service costs 13.4 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 $34,930MD $2,604
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.