How much rates vary
Facilitymedian $1,047 · 10th to 90th $151 to $5,623Professionalmedian $1,122 · 10th to 90th $813 to $3,311
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 $758.58 Median $831.76 Typical High $1,380.38 | Professional | None | $758.58 | $831.76 | $1,380.38 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $870.96 Median $1,258.93 Typical High $1,778.28 | Professional | None | $870.96 | $1,258.93 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $977.24 Typical High $4,466.84 | Facility | None | $54.95 | $977.24 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $10,000.00 | Professional | None | $870.96 | $977.24 | $10,000.00 |
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 $891.25 Typical High $1,698.24 | Professional | None | $870.96 | $891.25 | $1,698.24 |
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 $380.19 Median $407.38 Typical High $691.83 | Professional | 52 · Reduced service | $380.19 | $407.38 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $275.42 | Professional | 53 · Discontinued | $151.36 | $162.18 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $1,023.29 | Professional | 54 · Surgery only | $562.34 | $616.60 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $204.17 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $138.04 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $954.99 |
Where Kansas sits
The same service costs 18.1 times more in Maine than in Arkansas. 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 $27,451AR $1,513
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.