How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $2,089Professionalmedian $2,291 · 10th to 90th $1,698 to $3,890
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 $1,071.52 Median $1,862.09 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,862.09 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,778.28 | $2,290.87 | $2,290.87 |
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 $1,778.28 Median $3,311.31 Typical High $3,890.45 | Professional | None | $1,778.28 | $3,311.31 | $3,890.45 |
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 $1,621.81 Median $2,089.30 Typical High $3,890.45 | Professional | None | $1,621.81 | $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 $912.01 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $912.01 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $363.08 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,348.96 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $269.15 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $181.97 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,621.81 | $1,621.81 |
Where Arkansas sits
The same service costs 14.0 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 $34,704TX $2,477
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.