How much rates vary
Facilitymedian $2,455 · 10th to 90th $447 to $6,310Professionalmedian $2,089 · 10th to 90th $1,479 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 $1,288.25 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,288.25 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,905.46 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $2,754.23 | Professional | None | $1,698.24 | $2,290.87 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $1,258.93 | Facility | None | $549.54 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,737.80 | $2,089.30 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $2,454.71 Typical High $5,888.44 | Facility | None | $398.11 | $2,454.71 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $12,882.50 | Professional | None | $1,584.89 | $2,041.74 | $12,882.50 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,995.26 Typical High $6,025.60 | Facility | None | $426.58 | $1,995.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,479.11 | $1,862.09 | $2,754.23 |
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 $851.14 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,258.93 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $251.19 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,318.26 | $1,318.26 |
Where Oklahoma 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.