How much rates vary
Facilitymedian $3,090 · 10th to 90th $537 to $12,589Professionalmedian $3,890 · 10th to 90th $2,089 to $12,882
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 $1,548.82 Median $7,943.28 Typical High $21,877.62 | Facility | None | $1,548.82 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $3,467.37 | Professional | None | $1,548.82 | $1,548.82 | $3,467.37 |
BCBS Nebraska 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 $2,884.03 Median $3,981.07 Typical High $4,786.30 | Professional | None | $2,884.03 | $3,981.07 | $4,786.30 |
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 $2,454.71 Median $4,073.80 Typical High $12,882.50 | Professional | None | $2,454.71 | $4,073.80 | $12,882.50 |
Midlands Setting Professional Modifier None Typical Low $3,090.30 Median $3,981.07 Typical High $5,248.07 | Professional | None | $3,090.30 | $3,981.07 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $3,090.30 Median $3,890.45 Typical High $5,248.07 | Professional | None | $3,090.30 | $3,890.45 | $5,248.07 |
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 $2,454.71 Median $3,548.13 Typical High $4,570.88 | Professional | None | $2,454.71 | $3,548.13 | $4,570.88 |
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 $776.25 Median $776.25 Typical High $933.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | 53 · Discontinued | $309.03 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,288.25 |
Where Nebraska sits
The same service costs 7.6 times more in Maine 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
ME $18,140MD $2,382
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.