How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,096 to $8,913Professionalmedian $1,413 · 10th to 90th $1,202 to $10,000
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 $977.24 Median $5,623.41 Typical High $9,772.37 | Facility | None | $977.24 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,288.25 | $1,288.25 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,659.59 | $3,981.07 | $10,232.93 |
BCBS Arizona Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,513.56 | $1,513.56 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,089.30 Typical High $2,691.53 | Facility | None | $630.96 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,445.44 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $3,630.78 Typical High $10,232.93 | Facility | None | $954.99 | $3,630.78 | $10,232.93 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $2,089.30 Typical High $10,000.00 | Professional | None | $1,174.90 | $2,089.30 | $10,000.00 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,168.69 Typical High $8,317.64 | Facility | None | $977.24 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,318.26 | $1,862.09 |
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 $630.96 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $630.96 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $275.42 | Professional | 53 · Discontinued | $257.04 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,023.29 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $954.99 |
Where Arizona sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.