How much rates vary
Facilitymedian $1,047 · 10th to 90th $151 to $5,623Professionalmedian $1,585 · 10th to 90th $1,175 to $2,399
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 $5,495.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,905.46 | $1,905.46 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $2,041.74 | Facility | None | $446.68 | $645.65 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,621.81 | $1,995.26 |
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 $1,148.15 Median $1,737.80 Typical High $8,128.31 | Professional | None | $1,148.15 | $1,737.80 | $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 $1,148.15 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,737.80 | $2,398.83 |
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 $691.83 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $691.83 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $275.42 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,047.13 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $208.93 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $138.04 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $977.24 | $1,348.96 | $1,348.96 |
Where Kansas sits
The same service costs 9.9 times more in Alabama 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
AL $18,241MD $1,851
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.