How much rates vary
Facilitymedian $2,138 · 10th to 90th $447 to $6,310Professionalmedian $1,820 · 10th to 90th $1,349 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 $1,288.25 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,288.25 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,698.24 | $1,737.80 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,513.56 | $2,089.30 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $1,258.93 | Facility | None | $549.54 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,862.09 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $2,137.96 Typical High $5,888.44 | Facility | None | $398.11 | $2,137.96 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $11,220.18 | Professional | None | $1,380.38 | $1,819.70 | $11,220.18 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,995.26 Typical High $6,025.60 | Facility | None | $426.58 | $1,995.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,621.81 | $2,454.71 |
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 $741.31 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $741.31 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,174.90 |
Where Oklahoma 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.