How much rates vary
Facilitymedian $3,020 · 10th to 90th $603 to $6,607Professionalmedian $3,548 · 10th to 90th $1,995 to $5,012
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 $2,511.89 Median $5,888.44 Typical High $7,943.28 | Facility | None | $2,511.89 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $3,981.07 | Professional | None | $1,621.81 | $2,511.89 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $4,168.69 Typical High $4,897.79 | Professional | None | $3,388.44 | $4,168.69 | $4,897.79 |
Hally Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $4,570.88 | Professional | None | $1,659.59 | $2,691.53 | $4,570.88 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $3,311.31 Typical High $5,248.07 | Facility | None | $724.44 | $3,311.31 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $1,995.26 Median $3,890.45 Typical High $12,882.50 | Professional | None | $1,995.26 | $3,890.45 | $12,882.50 |
Midlands Setting Professional Modifier None Typical Low $3,548.13 Median $3,981.07 Typical High $4,897.79 | Professional | None | $3,548.13 | $3,981.07 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $3,548.13 Median $3,981.07 Typical High $5,888.44 | Professional | None | $3,548.13 | $3,981.07 | $5,888.44 |
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 $1,819.70 Median $2,691.53 Typical High $4,897.79 | Professional | None | $1,819.70 | $2,691.53 | $4,897.79 |
Wellmark Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,073.80 | Professional | None | $3,467.37 | $3,467.37 | $4,073.80 |
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 $812.83 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $812.83 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $323.59 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,202.26 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $239.88 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $162.18 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,737.80 | $1,737.80 |
Where Iowa sits
The same service costs 14.4 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 $34,547MD $2,395
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.