How much rates vary
Facilitymedian $1,047 · 10th to 90th $151 to $5,623Professionalmedian $2,138 · 10th to 90th $1,549 to $2,951
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 $2,187.76 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,187.76 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,659.59 | $2,187.76 | $2,187.76 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $2,041.74 | Facility | None | $446.68 | $676.08 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,513.56 | $2,041.74 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $4,466.84 | Facility | None | $54.95 | $1,000.00 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $10,471.29 | Professional | None | $1,513.56 | $2,187.76 | $10,471.29 |
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 $1,513.56 Median $2,187.76 Typical High $2,951.21 | Professional | None | $1,513.56 | $2,187.76 | $2,951.21 |
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 $831.76 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $831.76 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $331.13 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,621.81 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,258.93 | $1,621.81 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $251.19 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $165.96 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,513.56 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,513.56 | $1,548.82 |
Where Kansas sits
The same service costs 7.5 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 $16,075MD $2,147
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.