How much rates vary
Facilitymedian $4,677 · 10th to 90th $437 to $4,898Professionalmedian $2,138 · 10th to 90th $1,622 to $11,220
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 $2,511.89 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,511.89 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,621.81 | $1,862.09 | $2,511.89 |
BCBS Kansas Setting Facility Modifier None Typical Low $4,677.35 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,677.35 | $4,897.79 | $4,897.79 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,659.59 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,659.59 | $2,137.96 | $2,884.03 |
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 $1,621.81 Median $3,235.94 Typical High $11,220.18 | Professional | None | $1,621.81 | $3,235.94 | $11,220.18 |
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 $1,548.82 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,548.82 | $1,905.46 | $2,691.53 |
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 $812.83 Median $912.01 Typical High $1,258.93 | Professional | 52 · Reduced service | $812.83 | $912.01 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $371.54 Typical High $501.19 | Professional | 53 · Discontinued | $323.59 | $371.54 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,380.38 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,230.27 | $1,380.38 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $275.42 Typical High $380.19 | Professional | 55 · Aftercare only | $245.47 | $275.42 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $186.21 Typical High $251.19 | Professional | 56 · Pre-op care only | $162.18 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,288.25 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,288.25 | $1,778.28 |
Where Kansas sits
The same service costs 8.2 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 $17,891MD $2,184
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.