How much rates vary
Facilitymedian $1,096 · 10th to 90th $257 to $7,079Professionalmedian $1,738 · 10th to 90th $1,349 to $2,570
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 $3,090.30 Median $6,309.57 Typical High $9,772.37 | Facility | None | $3,090.30 | $6,309.57 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,905.46 | $1,905.46 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $1,258.93 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,621.81 | $2,089.30 |
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 $1,318.26 Median $1,862.09 Typical High $8,128.31 | Professional | None | $1,318.26 | $1,862.09 | $8,128.31 |
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 $1,230.27 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,862.09 | $2,511.89 |
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 $707.95 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $707.95 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $288.40 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,071.52 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $213.80 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $141.25 | $190.55 | $190.55 |
Where Kansas sits
The same service costs 15.0 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 $27,402MD $1,821
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.