How much rates vary
Facilitymedian $1,175 · 10th to 90th $174 to $4,898Professionalmedian $1,072 · 10th to 90th $955 to $7,943
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 $977.24 Median $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,047.13 | $1,819.70 |
Ambetter Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,778.28 | Professional | None | $891.25 | $891.25 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,691.53 | Facility | None | $602.56 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,047.13 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $1,096.48 Typical High $4,466.84 | Facility | None | $102.33 | $1,096.48 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $7,943.28 | Professional | None | $954.99 | $1,318.26 | $7,943.28 |
United Setting Facility Modifier None Typical Low $104.71 Median $1,148.15 Typical High $5,128.61 | Facility | None | $104.71 | $1,148.15 | $5,128.61 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,819.70 | Professional | None | $954.99 | $1,096.48 | $1,819.70 |
4 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 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $794.33 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $776.25 |
Where Arizona sits
The same service costs 9.4 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 $15,900MD $1,684
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.