How much rates vary
Facilitymedian $1,175 · 10th to 90th $479 to $6,607Professionalmedian $631 · 10th to 90th $355 to $912
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 $436.52 Median $5,888.44 Typical High $7,943.28 | Facility | None | $436.52 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $436.52 | Professional | None | $281.84 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $851.14 | Professional | None | $602.56 | $741.31 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $870.96 | Professional | None | $295.12 | $512.86 | $870.96 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $870.96 Typical High $5,011.87 | Facility | None | $446.68 | $870.96 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $724.44 Typical High $2,344.23 | Professional | None | $354.81 | $724.44 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $891.25 | Professional | None | $630.96 | $707.95 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $3,388.44 | Professional | None | $630.96 | $676.08 | $3,388.44 |
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 $323.59 Median $478.63 Typical High $870.96 | Professional | None | $323.59 | $478.63 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $707.95 | Professional | None | $602.56 | $602.56 | $707.95 |
3 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 54 · Surgery only Typical Low $208.93 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $208.93 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $41.69 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.18 | $43.65 | $43.65 |
Where Iowa sits
The same service costs 41.7 times more in Maine than in Delaware. 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 $33,502DE $803
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.