How much rates vary
Facilitymedian $3,090 · 10th to 90th $537 to $11,482Professionalmedian $2,239 · 10th to 90th $1,288 to $3,631
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 $912.01 Median $7,943.28 Typical High $21,877.62 | Facility | None | $912.01 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $2,398.83 | Professional | None | $912.01 | $1,096.48 | $2,398.83 |
Ambetter Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $1,659.59 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,659.59 | $2,290.87 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $4,365.16 | Facility | None | $478.63 | $954.99 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $2,344.23 Typical High $7,413.10 | Professional | None | $1,412.54 | $2,344.23 | $7,413.10 |
Midlands Setting Professional Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,819.70 | $2,290.87 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,819.70 | $2,238.72 | $3,019.95 |
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 $1,412.54 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,412.54 | $2,041.74 | $2,630.27 |
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 $446.68 Median $446.68 Typical High $524.81 | Professional | 52 · Reduced service | $446.68 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | 53 · Discontinued | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $794.33 | Professional | 54 · Surgery only | $676.08 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $741.31 |
Where Nebraska sits
The same service costs 10.5 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 $17,137MD $1,634
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.