How much rates vary
Facilitymedian $3,090 · 10th to 90th $537 to $12,303Professionalmedian $2,951 · 10th to 90th $1,549 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 $1,202.26 Median $7,943.28 Typical High $21,877.62 | Facility | None | $1,202.26 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,348.96 | $3,090.30 |
Ambetter Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $9,772.37 Typical High $19,952.62 | Facility | None | $7,413.10 | $9,772.37 | $19,952.62 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $3,715.35 | Professional | None | $2,187.76 | $3,019.95 | $3,715.35 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $977.24 Typical High $4,365.16 | Facility | None | $478.63 | $977.24 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $3,090.30 Typical High $9,772.37 | Professional | None | $1,862.09 | $3,090.30 | $9,772.37 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,981.07 | Professional | None | $2,398.83 | $3,019.95 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $3,981.07 | Professional | None | $2,398.83 | $2,951.21 | $3,981.07 |
United Setting Facility Modifier None Typical Low $489.78 Median $891.25 Typical High $3,801.89 | Facility | None | $489.78 | $891.25 | $3,801.89 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,691.53 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,691.53 | $3,467.37 |
7 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 $588.84 Median $588.84 Typical High $707.95 | Professional | 52 · Reduced service | $588.84 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 53 · Discontinued | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $213.80 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $977.24 |
Ambetter Setting Professional Modifier 22 · Increased work Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 22 · Increased work | $2,754.23 | $2,754.23 | $2,754.23 |
Where Nebraska sits
The same service costs 9.5 times more in Maine than in Texas. 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 $17,587TX $1,842
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.