How much rates vary
Facilitymedian $7,244 · 10th to 90th $513 to $7,413Professionalmedian $1,950 · 10th to 90th $1,549 to $3,548
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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $3,548.13 | Professional | None | $1,949.84 | $3,548.13 | $3,548.13 |
BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,244.36 | $7,413.10 | $7,413.10 |
BCBS Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $2,089.30 Median $2,691.53 Typical High $3,019.95 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $2,089.30 | $2,691.53 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $1,202.26 | Facility | None | $446.68 | $549.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,819.70 | $1,949.84 | $2,884.03 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $3,801.89 | Facility | None | $371.54 | $954.99 | $3,801.89 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,737.80 | $3,235.94 |
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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,630.27 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,454.71 | $2,454.71 |
Where Alabama sits
The same service costs 12.0 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 $28,594MD $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.