How much rates vary
Facilitymedian $1,950 · 10th to 90th $174 to $7,762Professionalmedian $1,479 · 10th to 90th $1,230 to $10,471
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 $5,495.41 Typical High $8,317.64 | Facility | None | $977.24 | $5,495.41 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,318.26 | $1,318.26 | $1,479.11 |
BCBS 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 Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,584.89 | $1,584.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,691.53 | Facility | None | $602.56 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,513.56 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $1,096.48 Typical High $5,128.61 | Facility | None | $102.33 | $1,096.48 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $10,471.29 | Professional | None | $1,230.27 | $1,778.28 | $10,471.29 |
United Setting Facility Modifier None Typical Low $104.71 Median $1,148.15 Typical High $5,128.61 | Facility | None | $104.71 | $1,148.15 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,380.38 | $1,905.46 |
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 $660.69 Median $660.69 Typical High $724.44 | Professional | 52 · Reduced service | $660.69 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | 53 · Discontinued | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,000.00 |
Where Arizona sits
The same service costs 8.5 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 $17,711MD $2,076
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.