How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $708 · 10th to 90th $110 to $1,445
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 $1,445.44 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,445.44 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,445.44 | $1,445.44 |
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 $1,148.15 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,230.27 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $676.08 Typical High $912.01 | Professional | None | $109.65 | $676.08 | $912.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,698.24 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $831.76 Median $1,659.59 Typical High $3,715.35 | Professional | None | $831.76 | $1,659.59 | $3,715.35 |
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 $912.01 Median $1,096.48 Typical High $2,041.74 | Professional | None | $912.01 | $1,096.48 | $2,041.74 |
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 $512.86 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $512.86 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $204.17 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $758.58 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $151.36 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $102.33 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $707.95 | $1,000.00 | $1,000.00 |
Where Utah sits
The same service costs 9.8 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 $16,204MD $1,659
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.