How much rates vary
Facilitymedian $912 · 10th to 90th $151 to $5,623Professionalmedian $372 · 10th to 90th $269 to $1,288
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 $1,698.24 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,698.24 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $457.09 | Professional | None | $251.19 | $288.40 | $457.09 |
BCBS Kansas Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $275.42 Median $380.19 Typical High $562.34 | Professional | None | $275.42 | $380.19 | $562.34 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $602.56 Typical High $4,466.84 | Facility | None | $54.95 | $602.56 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $4,265.80 | Professional | None | $269.15 | $316.23 | $4,265.80 |
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 $269.15 Median $281.84 Typical High $489.78 | Professional | None | $269.15 | $281.84 | $489.78 |
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 $125.89 Median $144.54 Typical High $229.09 | Professional | 52 · Reduced service | $125.89 | $144.54 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $57.54 Typical High $91.20 | Professional | 53 · Discontinued | $50.12 | $57.54 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $218.78 Typical High $338.84 | Professional | 54 · Surgery only | $186.21 | $218.78 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $43.65 Typical High $67.61 | Professional | 55 · Aftercare only | $37.15 | $43.65 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.84 Typical High $45.71 | Professional | 56 · Pre-op care only | $25.12 | $28.84 | $45.71 |
Where Kansas sits
The same service costs 32.0 times more in Maine than in Montana. 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 $26,674MT $834
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.