How much rates vary
Facilitymedian $1,096 · 10th to 90th $257 to $6,310Professionalmedian $1,202 · 10th to 90th $933 to $1,738
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 $4,786.30 Typical High $10,715.19 | Facility | None | $1,949.84 | $4,786.30 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,318.26 | Professional | None | $977.24 | $1,318.26 | $1,318.26 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $891.25 Median $1,122.02 Typical High $1,479.11 | Professional | None | $891.25 | $1,122.02 | $1,479.11 |
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 $912.01 Median $1,258.93 Typical High $5,623.41 | Professional | None | $912.01 | $1,258.93 | $5,623.41 |
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 $870.96 Median $1,258.93 Typical High $1,737.80 | Professional | None | $870.96 | $1,258.93 | $1,737.80 |
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 $489.78 Median $645.65 Typical High $660.69 | Professional | 52 · Reduced service | $489.78 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $194.98 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $741.31 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $147.91 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $97.72 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $691.83 | $912.01 | $912.01 |
Where Kansas sits
The same service costs 18.7 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 $26,826MD $1,433
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.