How much rates vary
Facilitymedian $2,884 · 10th to 90th $457 to $6,310Professionalmedian $3,467 · 10th to 90th $2,570 to $21,380
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 $1,288.25 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,288.25 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,445.44 Typical High $5,754.40 | Facility | None | $891.25 | $1,445.44 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,715.35 Typical High $4,168.69 | Professional | None | $3,090.30 | $3,715.35 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $3,981.07 Typical High $5,888.44 | Facility | None | $457.09 | $3,981.07 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $21,379.62 | Professional | None | $2,691.53 | $3,467.37 | $21,379.62 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,995.26 Typical High $6,025.60 | Facility | None | $426.58 | $1,995.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,511.89 | $3,162.28 | $4,168.69 |
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 $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,318.26 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,995.26 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $398.11 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,905.46 | $1,905.46 |
Where Oklahoma sits
The same service costs 11.5 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 $35,990TX $3,131
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.