How much rates vary
Facilitymedian $3,311 · 10th to 90th $603 to $6,607Professionalmedian $3,715 · 10th to 90th $2,138 to $5,370
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 $5,888.44 Typical High $7,943.28 | Facility | None | $2,630.27 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,698.24 | $2,630.27 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $4,365.16 Typical High $5,248.07 | Professional | None | $3,630.78 | $4,365.16 | $5,248.07 |
Hally Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,818.38 Typical High $4,786.30 | Professional | None | $1,778.28 | $2,818.38 | $4,786.30 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $3,388.44 Typical High $5,370.32 | Facility | None | $724.44 | $3,388.44 | $5,370.32 |
Medica Setting Professional Modifier None Typical Low $2,137.96 Median $4,073.80 Typical High $13,803.84 | Professional | None | $2,137.96 | $4,073.80 | $13,803.84 |
Midlands Setting Professional Modifier None Typical Low $3,715.35 Median $4,265.80 Typical High $5,248.07 | Professional | None | $3,715.35 | $4,265.80 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $3,630.78 Median $4,168.69 Typical High $6,165.95 | Professional | None | $3,630.78 | $4,168.69 | $6,165.95 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,918.31 | Facility | None | $588.84 | $2,344.23 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $5,128.61 | Professional | None | $1,905.46 | $2,818.38 | $5,128.61 |
Wellmark Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,265.80 | Professional | None | $3,630.78 | $3,630.78 | $4,265.80 |
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 $851.14 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $851.14 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $338.84 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,288.25 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $257.04 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $169.82 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,862.09 | $1,862.09 |
Where Iowa 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.