How much rates vary
Facilitymedian $3,236 · 10th to 90th $575 to $13,804Professionalmedian $1,413 · 10th to 90th $200 to $2,239
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 $3,162.28 Median $3,235.94 Typical High $6,025.60 | Facility | None | $3,162.28 | $3,235.94 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,290.87 | $3,235.94 | $3,235.94 |
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 $2,754.23 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,754.23 | $2,754.23 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $1,348.96 Typical High $1,905.46 | Professional | None | $194.98 | $1,348.96 | $1,905.46 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,630.78 Median $3,890.45 Typical High $4,365.16 | Professional | None | $3,630.78 | $3,890.45 | $4,365.16 |
Select Health Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
Select Health Setting Professional Modifier None Typical Low $2,454.71 Median $4,897.79 Typical High $5,754.40 | Professional | None | $2,454.71 | $4,897.79 | $5,754.40 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $2,041.74 Median $3,630.78 Typical High $7,762.47 | Professional | None | $2,041.74 | $3,630.78 | $7,762.47 |
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 $1,905.46 Median $2,290.87 Typical High $3,890.45 | Professional | None | $1,905.46 | $2,290.87 | $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 $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,318.26 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $537.03 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,995.26 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $398.11 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $269.15 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,238.72 | $2,238.72 |
Where Utah sits
The same service costs 13.8 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 $35,114TX $2,545
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.