How much rates vary
Facilitymedian $1,445 · 10th to 90th $490 to $5,623Professionalmedian $575 · 10th to 90th $427 to $3,162
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 $436.52 Median $512.86 Typical High $707.95 | Professional | None | $436.52 | $512.86 | $707.95 |
BCBS Kansas Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $426.58 Median $645.65 Typical High $776.25 | Professional | None | $426.58 | $645.65 | $776.25 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,096.48 Typical High $4,466.84 | Facility | None | $54.95 | $1,096.48 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $851.14 Typical High $3,162.28 | Professional | None | $457.09 | $851.14 | $3,162.28 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,737.80 Typical High $4,677.35 | Facility | None | $831.76 | $1,737.80 | $4,677.35 |
United Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $707.95 | Professional | None | $426.58 | $501.19 | $707.95 |
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 $218.78 Median $257.04 Typical High $346.74 | Professional | 52 · Reduced service | $218.78 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $102.33 Typical High $141.25 | Professional | 53 · Discontinued | $89.13 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $380.19 Typical High $524.81 | Professional | 54 · Surgery only | $331.13 | $380.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $75.86 Typical High $104.71 | Professional | 55 · Aftercare only | $66.07 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $51.29 Typical High $70.79 | Professional | 56 · Pre-op care only | $43.65 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $354.81 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $309.03 | $354.81 | $489.78 |
Where Kansas sits
The same service costs 11.6 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 $15,328MT $1,322
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.