How much rates vary
Facilitymedian $513 · 10th to 90th $309 to $2,188Professionalmedian $2,455 · 10th to 90th $1,820 to $4,169
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 $2,511.89 | Facility | None | $1,071.52 | $1,862.09 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,905.46 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,778.28 | Facility | None | $501.19 | $501.19 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $4,168.69 | Professional | None | $1,905.46 | $3,548.13 | $4,168.69 |
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 $1,737.80 Median $2,238.72 Typical High $4,265.80 | Professional | None | $1,737.80 | $2,238.72 | $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 $1,023.29 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,023.29 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,513.56 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $302.00 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,737.80 | $1,737.80 |
Where Arkansas sits
The same service costs 12.5 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 $34,871MD $2,784
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.