How much rates vary
Facilitymedian $1,000 · 10th to 90th $123 to $5,623Professionalmedian $1,514 · 10th to 90th $1,230 to $2,291
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 $1,949.84 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,737.80 | $1,737.80 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $2,041.74 | Facility | None | $446.68 | $602.56 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,348.96 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $851.14 Typical High $4,570.88 | Facility | None | $54.95 | $851.14 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $7,413.10 | Professional | None | $1,202.26 | $1,659.59 | $7,413.10 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,000.00 Typical High $5,248.07 | Facility | None | $407.38 | $1,000.00 | $5,248.07 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,659.59 | $2,290.87 |
5 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 $660.69 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $660.69 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $263.03 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,288.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $977.24 | $1,288.25 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $257.04 Typical High $263.03 | Professional | 55 · Aftercare only | $194.98 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $131.83 | $173.78 | $173.78 |
Where Kansas sits
The same service costs 57.9 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 $103,808MD $1,793
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.