How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,660 to $8,913Professionalmedian $1,950 · 10th to 90th $1,445 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 $2,884.03 Median $6,456.54 Typical High $10,964.78 | Facility | None | $2,884.03 | $6,456.54 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,445.44 | $1,659.59 | $2,238.72 |
BCBS Kansas Setting Facility Modifier None Typical Low $4,073.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,073.80 | $4,265.80 | $4,265.80 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $676.08 Typical High $2,041.74 | Facility | None | $478.63 | $676.08 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,513.56 | $2,089.30 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $2,691.53 Typical High $10,232.93 | Facility | None | $1,202.26 | $2,691.53 | $10,232.93 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $10,000.00 | Professional | None | $1,445.44 | $2,884.03 | $10,000.00 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,570.40 Typical High $8,709.64 | Facility | None | $870.96 | $2,570.40 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,698.24 | $2,398.83 |
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 $724.44 Median $831.76 Typical High $1,122.02 | Professional | 52 · Reduced service | $724.44 | $831.76 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $331.13 Typical High $457.09 | Professional | 53 · Discontinued | $295.12 | $331.13 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,230.27 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,096.48 | $1,230.27 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $245.47 Typical High $338.84 | Professional | 55 · Aftercare only | $218.78 | $245.47 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $165.96 Typical High $223.87 | Professional | 56 · Pre-op care only | $144.54 | $165.96 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,148.15 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,148.15 | $1,584.89 |
Where Kansas 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.