How much rates vary
Facilitymedian $1,047 · 10th to 90th $151 to $5,623Professionalmedian $1,660 · 10th to 90th $1,259 to $8,710
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 $1,995.26 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,995.26 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,445.44 | $1,995.26 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $2,041.74 | Facility | None | $446.68 | $676.08 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,698.24 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $4,466.84 | Facility | None | $54.95 | $1,000.00 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $2,511.89 Typical High $8,709.64 | Professional | None | $1,258.93 | $2,511.89 | $8,709.64 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,000.00 Typical High $5,248.07 | Facility | None | $407.38 | $1,000.00 | $5,248.07 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,479.11 | $2,089.30 |
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 $645.65 Median $724.44 Typical High $1,000.00 | Professional | 52 · Reduced service | $645.65 | $724.44 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $398.11 | Professional | 53 · Discontinued | $257.04 | $288.40 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,071.52 Typical High $1,479.11 | Professional | 54 · Surgery only | $954.99 | $1,071.52 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $213.80 Typical High $295.12 | Professional | 55 · Aftercare only | $190.55 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $199.53 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,000.00 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $891.25 | $1,000.00 | $1,380.38 |
Where Kansas sits
The same service costs 5.9 times more in Alabama 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
AL $10,682MD $1,821
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.