How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $1,047 · 10th to 90th $141 to $1,950
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 $2,187.76 Median $3,162.28 Typical High $6,025.60 | Facility | None | $2,187.76 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,445.44 | $2,187.76 | $2,187.76 |
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 $1,778.28 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,778.28 | $1,862.09 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $954.99 Typical High $1,348.96 | Professional | None | $138.04 | $954.99 | $1,348.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $4,466.84 | Professional | None | $2,454.71 | $2,884.03 | $4,466.84 |
Select Health Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,318.26 Median $2,570.40 Typical High $5,128.61 | Professional | None | $1,318.26 | $2,570.40 | $5,128.61 |
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 $1,445.44 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,698.24 | $3,162.28 |
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 $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $794.33 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $316.23 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,174.90 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $239.88 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $158.49 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,513.56 | $1,513.56 |
Where Utah sits
The same service costs 15.5 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 $34,449MD $2,222
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.