How much rates vary
Facilitymedian $1,096 · 10th to 90th $151 to $6,918Professionalmedian $2,291 · 10th to 90th $1,778 to $3,388
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 $3,162.28 Median $5,495.41 Typical High $11,748.98 | Facility | None | $3,162.28 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $2,951.21 | Professional | None | $1,862.09 | $2,511.89 | $2,951.21 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $1,698.24 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,698.24 | $2,137.96 | $2,818.38 |
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 $1,737.80 Median $2,454.71 Typical High $10,715.19 | Professional | None | $1,737.80 | $2,454.71 | $10,715.19 |
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 $1,659.59 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,659.59 | $2,454.71 | $3,311.31 |
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 $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $933.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $371.54 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,412.54 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $371.54 Typical High $380.19 | Professional | 55 · Aftercare only | $281.84 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $186.21 | $251.19 | $251.19 |
Where Kansas sits
The same service costs 24.1 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 $53,525MD $2,222
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.